{"entity":{"id":"idea-bio2-nk-cells-for-mrd","kind":"idea","name":"Off-the-shelf natural killer cells to sweep up residual disease","aka":[],"tldr":"Donor immune cells that need no matching could be given as short courses to clear the few cancer cells left after surgery, when the target is smallest.","summary":"Allogeneic natural killer and CAR-NK products have been limited by short persistence and modest activity against bulky solid tumours, but persistence matters far less when the target is a handful of disseminated cells. Combined with a cytokine support agent, repeat dosing in the molecular residual disease window is a rational use of a product class that has struggled in advanced disease.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Dormant cells and minimal residual disease): Tie et al., ctDNA analysis guiding adjuvant therapy in stage II colon cancer (NEJM 2022)","url":"https://doi.org/10.1056/NEJMoa2200075"}],"tags":[],"related":[],"cancers":["colorectal","tnbc"],"sections":[],"technologies":["car-nk-macrophage","allogeneic-cell-therapy","mrd-testing"],"targets":[],"drugs":["nogapendekin-alfa"],"companies":["nkarta","fate-therapeutics","immunitybio"],"institutions":[],"pathways":[],"terms":["mrd","crs"],"trials":[],"people":[],"bottlenecks":["b-dormancy-mrd","b-manufacturing-cell-therapy"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Repeat-dosed allogeneic NK cell therapy converts ctDNA-positive post-surgical patients to ctDNA-negative more often than standard care, with no cytokine release syndrome above grade 2.","rationale":"NK cells kill single cells in circulation and marrow efficiently and do not require antigen presentation or HLA matching, so they suit a low-burden, wide-antigen setting. Off-the-shelf supply makes rapid treatment after a positive test feasible.","test":"A phase 2 single-arm study in ctDNA-positive colorectal or breast cancer with molecular clearance at six months as primary endpoint, and paired marrow sampling to confirm disseminated cell clearance.","maturity":"preclinical-evidence","actor":"industry","cost":"medium","horizonYears":7},"route":"/ideas/idea-bio2-nk-cells-for-mrd/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"allogeneic-cell-therapy","kind":"technology","name":"Allogeneic (off-the-shelf) cell therapy","route":"/technologies/allogeneic-cell-therapy/"},{"id":"car-nk-macrophage","kind":"technology","name":"CAR-NK & CAR-macrophage","route":"/technologies/car-nk-macrophage/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"drug":[{"id":"nogapendekin-alfa","kind":"drug","name":"Nogapendekin alfa inbakicept","route":"/drugs/nogapendekin-alfa/"}],"company":[{"id":"fate-therapeutics","kind":"company","name":"Fate Therapeutics","route":"/companies/fate-therapeutics/"},{"id":"immunitybio","kind":"company","name":"ImmunityBio","route":"/companies/immunitybio/"},{"id":"nkarta","kind":"company","name":"Nkarta","route":"/companies/nkarta/"}],"term":[{"id":"crs","kind":"term","name":"Cytokine release syndrome (CRS)","route":"/terms/crs/"},{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"}],"bottleneck":[{"id":"b-dormancy-mrd","kind":"bottleneck","name":"Dormant cells and minimal residual disease","route":"/bottlenecks/b-dormancy-mrd/"},{"id":"b-manufacturing-cell-therapy","kind":"bottleneck","name":"Manufacturing cost and time for living and radioactive medicines","route":"/bottlenecks/b-manufacturing-cell-therapy/"}]}}