Over the past 5 years, immunotherapies have transformed the treatment landscape and the outcomes of patients with cancer. “Such is the impact of these new therapies that all our clinics and treatment chairs are full”, explains James Spicer, member of the scientific committee of the New directions in immuno-oncology conference that was held in London in September 2019. This event, a Cancer Research UK initiative, brought together an interdisciplinary group of leaders in the field. In the inaugural address, attendees were reminded that improvements of the current treatment options will only be achieved through collaboration. Indeed, in their presentations, most speakers acknowledged the importance of collaboration in their research.

In this conference, we heard examples of treatments for solid tumours as well as haematological malignancies. All immunotherapy modalities were discussed, from immune-checkpoint inhibition and adoptive cell therapies to vaccine-based approaches and strategies aimed at modulating the microbiome, which was highlighted by Jennifer Wargo as a key element in the response to immunotherapies.

Some sessions were dedicated to discussing the function of several elements of the immune system, such as macrophages, natural killer cells, myeloid-derived stem cells and different subsets of T cells. A common message in these presentations is that, owing to the high degree of adaptability of immunity, immune cell subtypes cannot be considered to have either a tumour-promoting or tumour-suppressing function. A better understanding of distinct immune cell subpopulations will enable the administration of therapies targeting only relevant subsets, with increased efficacy and reduced toxicities.

The concepts of evolution and heterogeneity were addressed by Alberto Bardelli, Joop Jansen, Samra Turajlic and Ash Alizadeh, who presented results of their studies on the molecular mechanisms underlying neoantigen presentation. Other key elements of antitumour immunity, such as the complement pathway, immune surveillance and innate immunity, were presented by Dimitrios Mastellos, Adrian Hayday and Eileen Parkes, respectively. The resulting picture is that of a complex network of immune pathways, all with clinical potential.

Several presentations addressed the growing number of digital tools that are enabling analyses of the intricacies of antitumour immunity. For example, the availability of algorithms that integrate single-cell data could facilitate the design of personalized immunotherapies and real-time monitoring of the response to such treatments.

In summary, the multifaceted nature of antitumour immunity was highlighted throughout the conference. Addressing this complexity in the clinic is not an easy task, but collaborative research has already resulted in favourable outcomes in the field — the facilitation of interactions between researchers can ensure the continuity of this trend.