Nanobiotix, a late clinical-stage nanomedicine company pioneering new approaches to the treatment of cancer, has recently announced its intention to start a new trial in the company’s immuno-oncology (IO) program. The trial is aimed at expanding the potential of NBTXR3 to recurrent and metastatic disease. The trial would target recurrent head and neck, and metastatic lung cancer patients. Studies indicate that the vast majority of oncology patients do not respond to checkpoint inhibitors. Nanobiotix will evaluate its lead product, NBTXR3, in combination with immune checkpoint inhibitors, with the aim of unlocking their vast potential to convert refractory patients into responders. For the past decade, there has been excitement around immuno-oncology agents’ capacity to boost the immune system’s response, priming it for an active attack against tumor cells. The response to checkpoint inhibitors in so-called “hot” tumors, infiltrated by T-cells and characterized by an inflammatory profile, has been striking with long-lasting clinical benefits in many cancer patients. However, many tumors exhibit little or no response to therapies targeting the immune system and are considered “cold”, due to a lack of immunogenicity. According to published data, only 15 to 20% of non-small-cell lung cancer patients (NSCLC), and 13 to 22% of head and neck squamous cell carcinoma patients (NHSCC) respond to immunotherapy treatments. Moreover, treatment using checkpoint inhibitors is generally not effective against all tumor types (“cold” tumors devoid of T-cell saturation, PD-1/PDL-1 blockage cannot drive an anti-cancer response). The physical mode of action and subsequent cell death generated by NBTXR3 induce a different immunogenicity compared to radiotherapy and chemotherapy. This could be the key to significantly increasing the number of cancer patients who can benefit from immuno-oncology strategies. As Nanobiotix reported earlier this year at ASCO 2017, NBTXR3 activated by radiotherapy was shown to induce a specific adaptive immune pattern that could potentially convert a non-responder into an immune-responsive patient receptive to treatment with checkpoint inhibitors. On top of NBTXR3’s core developments as a single agent across seven oncology indications, Nanobiotix’s Immuno-Oncology combination program opens the door to new developments, potential new indications, and important value creation opportunities.