I agree with Misiu and think we need to be careful about

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Plotinus
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I agree with Misiu and think we need to be careful about drawing limits around a drugs ability and the potential need for other therapies particularly in the case of Leronlimab without a full airing out in clinical trials and I for one would like to see it used on the front end, not the back end when a patient’s body has been ravaged and we are looking at salvage therapy. The prospective trial use of Leronlimab for breast cancer in a neoadjuvant setting is an example of this. IMHO with respect to Leronlimab it is not like it gets you to the river Styx and you need Charon (think ICI) to ferry you across to the other side. That said cancer, like viruses, has a propensity to morph, mutate weave and dodge for selective advantage and there will undoubtedly be cases where a check-mate with an ICI is the game winning play. 
The core of my bias comes down to this: the immune system is an absolute genius bit of biologic engineering. It was as though you could remember every person you ever met AND you knew if they were friend or foe. Further, if foe you were like some of the Marvel characters (shout out to Captain America on this board) that get stuff done. Leronlimab has multiple mechanisms of action in cancer but a critical one involves the repolarization of macrophages, unleashing the Marvel universe against the cancer. Inhibiting VEG-F is another important adjunctive move, inhibiting blood supply to the tumor and working against metastasis.
I think we also need to give full respect for the headwinds some of these other agents cost the body. For example oxaliplatin is used to treat CRC. Its mechanism of action involves damaging DNA and it is not selective for the cells it damages but proportionally hitting rapidly dividing cells more, so it is useful, the human body pays a price. Nausea vomiting and diarrhea are common with oxaliplatin in part because the cells of the GI tract turn over at a fairly rapid rate. A cursory look at the side effects of many cancer drugs makes one hope for an agent with outsized impact largely devoid of serious SAE’s. In the future I suspect oncologists will reach for Leronlimab first.

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