{"entity":{"id":"engineered-bacteria-therapy","kind":"technology","name":"Engineered bacteria as living cancer drugs","aka":[],"tldr":"Bacteria that seek out the low-oxygen core of tumours, then manufacture a drug on the spot.","summary":"Attenuated Salmonella and other anaerobes colonise hypoxic tumour cores that drugs reach poorly, and can be engineered to secrete cytokines or enzymes. Live programmes on ClinicalTrials.gov in September 2026 include SGN1, an engineered Salmonella expressing methioninase (NCT05038150 and NCT05103345, phase 1/2, recruiting), and Saltikva, a Salmonella carrying IL-2, in phase 2 in metastatic pancreatic cancer (NCT04589234). The field has a long history of tolerable but ineffective results, beginning with VNP20009 in the 2000s.","status":"phase-2","asOf":"2026-09-08","links":[{"label":"SGN1 phase 1/2 (NCT05038150)","url":"https://clinicaltrials.gov/study/NCT05038150"},{"label":"Saltikva phase 2 (NCT04589234)","url":"https://clinicaltrials.gov/study/NCT04589234"}],"tags":["frontier","radical"],"related":["bacterial-vector-vaccines"],"cancers":["pancreatic"],"sections":["immunotherapy","drug-discovery"],"technologies":["oncolytic-virus","cytokine-therapy","sting-agonist"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Attenuated bacteria given intravenously or intratumourally replicate selectively in hypoxic, necrotic tumour regions and express a therapeutic payload locally.","strengths":["Reaches hypoxic cores that chemotherapy and radiation miss","Payload made in situ, so systemic exposure is low","Strongly immunogenic, which can convert cold tumours"],"limitations":["Historical trials showed colonisation without responses","Sepsis and endotoxin risk forces heavy attenuation, which cuts potency","Regulatory and biosafety burden of a replicating organism"]},"route":"/technologies/engineered-bacteria-therapy/","neighbours":{"technology":[{"id":"bacterial-vector-vaccines","kind":"technology","name":"Bacterial vector cancer vaccines","route":"/technologies/bacterial-vector-vaccines/"},{"id":"bcg-vaccine-manufacturing","kind":"technology","name":"BCG manufacturing and the bladder cancer BCG shortage","route":"/technologies/bcg-vaccine-manufacturing/"},{"id":"cytokine-therapy","kind":"technology","name":"Cytokines & engineered cytokines","route":"/technologies/cytokine-therapy/"},{"id":"oncolytic-virus","kind":"technology","name":"Oncolytic viruses","route":"/technologies/oncolytic-virus/"},{"id":"sting-agonist","kind":"technology","name":"STING & innate immune agonists","route":"/technologies/sting-agonist/"}],"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"section":[{"id":"drug-discovery","kind":"section","name":"Drug Discovery Platforms","route":"/fronts/drug-discovery/"},{"id":"immunotherapy","kind":"section","name":"Immunotherapy","route":"/fronts/immunotherapy/"}],"roadmap":[{"id":"frontier-2035","kind":"roadmap","name":"Radical oncology: what could change the war by 2035","route":"/roadmaps/frontier-2035/"}]}}