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88 reviewsOur ability to use engineered bacteria for and 2018 because of a cluster of trials testing Listeria monocytogenesstrains as cancer vaccines. Company formation accelerated from an cancer therapy is rapidly expanding. A survey average of 0.7 per year between 1995 and 2015 to 2.2 per year from of preclinical, clinical and commercial eforts 2015 to 2020. Currently, 9 of the 16 active companies have candidates in clinical trials (Supplementary Table 3), with approximately provides an overview of the state of the feld, $185 million in private funds raised.revealing trends that could inform future Over 40 bacterial species have been engineered for cancer therapy directions.(Fig. 1b). Two species account for more than three-quarters of all trials: L. monocytogenes and Salmonella enterica (chiefly serovars Typhi and Typhimurium). Although phylogenetically distinct (Listeria is Bacteria are emerging as a promising class of living medicines for Gram-positive, Salmonella Gram-negative), these species share key solid tumors1–6 — a trend driven by broad advances in synthetic similarities: both are facultative anaerobes and facultative intracellular biology7, microbiome research8 and immuno-oncology9. While canpathogens, that is, capable of growing outside of cells but also capable cer treatments such as cell therapies, nanoparticles, oncolytic viruses, of entering host cells. Both species were first used as engineered cancer vaccines and protein biologics have demonstrated successes, they still therapies around 1995, growing out of the development of attenuated face challenges, including limited tumor penetration, lack of target strains intended for use as vaccines, much like BCG. L. monocytogenesantigens (or their loss), toxicity and tumor heterogeneity. The remarkis specialized to enter the cytosol of infected cells, which activates able ability of bacteria to colonize solid tumors regardless of antigenic desirable immune