# Trained innate immunity

Source: https://onco.cc/technologies/trained-innate-immunity/  
OnCo record `trained-innate-immunity` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Giving the innate immune system a memory, so monocytes and NK cells respond harder the next time they meet a tumour.

## Summary

BCG, the oldest immunotherapy, works partly by epigenetically reprogramming myeloid progenitors, an effect now called trained immunity. Beta-glucans and other agonists are being tested to induce the same state deliberately, alone or before checkpoint blockade. Evidence in cancer beyond intravesical BCG is early, and the same reprogramming can be immunosuppressive in the wrong context.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-09-08
- Tags: frontier
- Principle: Epigenetic and metabolic rewiring of haematopoietic progenitors produces monocytes and NK cells with heightened effector responses lasting months.
- Strengths: Cheap agonists, some already licensed; Independent of tumour antigen and of T cells; Clear precedent in bladder cancer
- Limitations: Little cancer-specific clinical data outside BCG; The direction of effect can reverse; No standard assay to confirm training in patients

## Sources

- ClinicalTrials.gov: trained immunity cancer: https://clinicaltrials.gov/search?term=trained%20immunity%20cancer

## Connected records

- cancers: [Bladder & urothelial cancer](https://onco.cc/cancers/urothelial/)
- fronts: [Immunotherapy](https://onco.cc/fronts/immunotherapy/), [Prevention & Risk](https://onco.cc/fronts/prevention/)
- technologies: [CAR-NK & CAR-macrophage](https://onco.cc/technologies/car-nk-macrophage/), [Cytokines & engineered cytokines](https://onco.cc/technologies/cytokine-therapy/), [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy)](https://onco.cc/technologies/bcg-and-intravesical-therapy/)
- companies: [HiberCell](https://onco.cc/companies/hibercell/)
- roadmaps: [Paths to cures: interception, eradication, control](https://onco.cc/roadmaps/cure-paths/), [Radical oncology: what could change the war by 2035](https://onco.cc/roadmaps/frontier-2035/)
- pathways: [Myeloid suppression: TAMs, MDSCs & don't-eat-me signals](https://onco.cc/pathways/myeloid-suppression-axis/)

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