European journal of cancer (Oxford, England : 1990)Jan 22, 2020

Immune-based treatments delivered directly inside tumors in cancer

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 4, 2026

Abstract

Intratumoural therapies may convert a 'cold' immune-inert tumour microenvironment into a 'hot' immune-inflamed one.

Immune checkpoint inhibitors are the standard care for many tumours but many patients do not benefit due to a lack of T-cell inflammation.
Directly injected intratumoural therapies could stimulate T-cell inflammation.
Current approaches under clinical development include chemoablation, oncolytic viral therapy, cytokines, and agents targeting innate immunity.
Melanoma is currently leading in intratumoural drug development due to its immunogenic properties.
Advancements in endoscopic and interventional radiological techniques are enabling injections into visceral lesions.

Simplified

Although immune checkpoint inhibitors have become the standard of care for many tumours, the majority of patients fail to achieve sustained benefit, often owing to the lack of a T-cell inflamed tumour microenvironment (TME). Directly injected intratumoural therapies present a potential strategy to induce T-cell inflammation and convert a 'cold' immune-inert TME into a 'hot' immune-inflamed TME. Various approaches including chemoablation, oncolytic viral therapy, cytokines and agents targeting innate immunity such as Toll-like receptor agonists and stimulator of interferon genes agonists are in clinical development. Thus far, melanoma has led the way in intratumoural drug development owing to its relative immunogenicity and propensity for cutaneous metastasis easily amenable to injections. However, intratumoural therapies are moving to other tumour types and advances in endoscopic and interventional radiological techniques are allowing these agents to be injected into visceral lesions. This review provides an overview of the current status of intratumoural therapies in oncology, as well as future directions regarding therapeutic niches and appropriate trial design for intratumoural agents.

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Competing interests

Conflict of interest statement W.X. serves on the advisory board for and reports speaker's fees and research funding from Merck Serono and speaker's fees from MSD; V.G.A. serves on the advisory boards for BMS, MSD, Merck Serono, Novartis, Pierre Fabre and Roche, reports speaker's fees from BMS, Merck Serono, MSD, Novartis, Pierre Fabre and Roche and reports Travel Support from BMS; A.M.M. serves on the advisory boards for BMS, MSD, Novartis, Roche and Pierre Fabre.

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Immune-based treatments delivered directly inside tumors in cancer

Abstract

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Competing interests

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