Controversies in upper gastrointestinal cancers: adoptive cell therapies

Adoptive cell therapies are transforming the treatment landscape in several solid and haematological malignancies. However, their application to oesophageal and gastric cancers (collectively referred to as OGCs) has been comparatively limited. Multiple factors contribute to this under-representation: absence of a prevalent mutation/aberrantly expressed that can be targeted (e.g. CD20 in B-cell malignancies), dominant immunosuppressive myeloid and stromal niches, low frequencies of naturally expanded tumour-reactive T cells, limited access to fresh tumour material for manufacturing, and the rapid clinical decline seen in many patients at the time eligibility could be established.