Mathematical Model Points to Ways of Rewiring Tumors for Stronger Cancer Drug Delivery

Cancer immunotherapy has produced remarkable successes in recent years, yet a stubborn problem continues to limit how many patients benefit from the newest generation of engineered antibodies: the tumors themselves are physically hostile territory for drugs. A research collaboration between Mass General Brigham and the University of Cyprus has now built a detailed mathematical model that captures this hostility in quantitative terms, and the model’s predictions point toward a practical strategy for making a promising class of therapies work better. The work, led by Rakesh Jain of the Department of Radiation Oncology at Mass General Brigham, was published in the Journal for ImmunoTherapy of Cancer on September 1, 2026.

The therapy at the center of the study belongs to a category known as immunomodulatory antibody-drug conjugates, or IM-ADCs. Antibody-drug conjugates are often described as biological guided missiles: an antibody engineered to recognize a molecule on cancer cells is chemically linked to a potent payload, allowing the drug to be delivered preferentially to the tumor rather than circulating freely through the body. The experimental compound examined here, called HE-S2, adds an immune dimension to this design. It pairs an antibody directed against PD-L1, a molecular brake that tumors use to suppress anti-cancer immune responses, with an immune-stimulating payload known as D18. In principle, such a construct should do more than kill cells directly; it should also help awaken the immune system inside the tumor.

Whether that principle survives contact with a real tumor depends heavily on the tumor microenvironment, the dense and disordered ecosystem of cells, vessels, and structural molecules that surrounds malignant cells. Tumor blood vessels are notoriously abnormal. They grow quickly and chaotically under the influence of pro-angiogenic signals, producing vessels that are leaky, irregularly branched, and poorly organized. That leakiness, combined with the absence of functional lymphatic drainage inside many tumors, drives up interstitial fluid pressure, the pressure of the fluid that permeates the tissue between cells. Elevated interstitial fluid pressure works against drug delivery by opposing the movement of molecules from vessels into tumor tissue, creating a physical barrier even when a drug is present in the bloodstream.

Capturing all of this computationally is a formidable task. The model developed by the team incorporates the key features that govern whether an IM-ADC can reach and influence a tumor: the structure and function of abnormal blood vessels, the elevated interstitial fluid pressure that impedes transport, the activity of immune cells within the tumor, the transport dynamics of the drug itself, and the behavior of tumor-draining lymph nodes, which are both sites of immune activation and potential routes of metastatic spread. By fitting the model to data from previously published mouse studies, the researchers were able to reproduce the tumor responses observed in those experiments. That step matters because a model that cannot recapitulate known outcomes has little credibility when used to predict anything new.

With the model calibrated, the team could explore biological processes that are difficult or impossible to measure directly in a living animal. One clear conclusion emerged from the simulations: HE-S2 was more effective as a treatment than either of its individual components delivered alone. That finding supports the underlying logic of the conjugate design. An anti-PD-L1 antibody by itself can release an immune brake, and an immune-stimulating payload by itself can push immune cells toward activity, but coupling the two in a single molecule that concentrates at the tumor appears to produce an effect greater than the sum of its parts. For a field in which combination immunotherapies often come with compounded toxicities, a single agent that delivers two mechanisms to the same site is an attractive proposition.

Perhaps the most consequential insight from the modeling work concerns a self-reinforcing loop between tumor size and drug delivery. According to the simulations, as the therapy shrinks the tumor, the interstitial fluid pressure within it decreases. Lower fluid pressure makes it easier for the drug to move from blood vessels into tumor tissue, which improves delivery and further enhances treatment effectiveness. In other words, early success begets greater success: each reduction in tumor burden relaxes the physical barriers that were limiting the drug, allowing more of it to penetrate the remaining tumor. This positive feedback loop offers a quantitative explanation for why solid tumors can be so resistant at the start of treatment and yet, once therapy gains traction, become progressively more vulnerable.

The model also sounds a cautionary note about a strategy that might otherwise seem obviously beneficial. For years, researchers including Jain’s group have explored approaches to normalize tumor vasculature, pruning the chaotic, leaky vessels of a tumor so that they more closely resemble the orderly vessels of healthy tissue. Normalized vessels carry blood more efficiently and can improve oxygenation, which in turn can support immune cell function. But the new model reveals a trade-off with a precise physical threshold. Antibody-drug conjugates are large-molecule therapeutics, and to escape from vessels into tumor tissue they depend on pores in the vessel wall of at least 40 nanometers in size. If vascular normalization is pushed too far, vessel walls become too tight, those pores close, and the very drugs the strategy is meant to deliver can no longer reach their targets.

This trade-off reframes vascular normalization not as a simple on-or-off intervention but as a window of opportunity with defined boundaries. The ideal approach, the results suggest, is to improve blood vessel function enough to lower interstitial fluid pressure and enhance perfusion, while preserving sufficient vascular permeability to allow large antibody-based therapies to penetrate the tumor. The model provides a way to reason quantitatively about where that window lies, which is precisely the kind of guidance that trial-and-error experimentation in animals struggles to deliver. Instead of guessing at dosing and timing for vessel-targeting combinations, researchers can use the model to identify conditions that keep delivery pathways open while reaping the benefits of a less hostile microenvironment.

The broader significance of the work lies in its methodological contribution as much as its specific findings. Experimental studies of the tumor microenvironment are constrained by what can be measured: imaging, biopsies, and biomarkers offer snapshots of processes that unfold continuously across space and time. A mechanistic model fitted to real data can fill in the gaps, estimating quantities such as local fluid pressure, drug penetration depth, and immune cell dynamics in regions and moments that no assay can reach. When such a model accurately reproduces observed tumor responses, it becomes a virtual laboratory for testing hypotheses, for instance about how altering vessel function at different times might shift the balance between drug delivery and immune activation, before any new animal or human study is launched.

The results lend support to treatment strategies aimed at normalizing the tumor microenvironment before administering antibody-drug conjugate therapy, a sequencing concept that could influence how future clinical regimens are designed. As IM-ADCs and related constructs move through development, the ability to model the interplay between tumor physics and drug pharmacology may help identify which patients are most likely to respond, and which combinations of pre-treatment interventions could convert non-responders into responders. The study, conducted in the tradition of translational research that connects physical science with oncology, suggests that the next advances in antibody-based cancer therapy may come not only from better drugs, but from a deeper understanding of the terrain those drugs must cross.

Subject of Research: Mechanistic modeling of the tumor immune microenvironment to improve immunomodulatory antibody-drug conjugate therapy

Article Title: Model reveals strategies to modify the tumor microenvironment and improve cancer therapy

Article References: Model reveals strategies to modify the tumor microenvironment and improve cancer therapy. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: antibody-drug conjugates, tumor microenvironment, mathematical modeling, immunotherapy, PD-L1, interstitial fluid pressure, vascular normalization, drug delivery, cancer research, HE-S2, tumor vasculature, Mass General Brigham