A new cancer therapy called Antkiva is officially approved in the United States for a narrow form of bladder cancer. Yet its underlying biology, expanding international approvals, and early results in some of the hardest cancers to treat are driving a much larger and more provocative idea. This treatment may represent the first truly general purpose immune based cancer therapy, one that works without surgery or chemotherapy and could eventually be available to anyone.
Antkiva is the brand name for nogapendekin alfa inbakicept pmln, an immunotherapy developed by ImmunityBio. It belongs to a class of drugs known as interleukin 15 agonists. Instead of attacking tumors directly, Antkiva stimulates the immune system itself, expanding natural killer cells and killer T cells that are capable of recognizing and destroying cancer cells.
Unlike chemotherapy, which kills dividing cells indiscriminately, Antkiva is designed to generate immune memory. The goal is not just an initial response, but a lasting population of trained immune cells that continue to hunt cancer long after treatment ends.
How It Works in Bladder Cancer
In the United States, Antkiva is approved for patients with BCG unresponsive non muscle invasive bladder cancer that includes carcinoma in situ. These are patients for whom standard immune therapy using BCG has failed and whose next option is often removal of the bladder.
Antkiva is delivered directly into the bladder through a catheter and is used together with BCG. This localized delivery allows intense immune activation where the cancer exists, without exposing the entire body to systemic toxicity.
In clinical trials led by UCLA, patients who received Antkiva together with BCG were far more likely to avoid radical bladder surgery. More than half of patients had a complete response at three and six months, and nearly half remained cancer free at one year. The median time patients stayed cancer free was just over nineteen months, a meaningful result in a disease known for recurrence.
For patients facing the loss of their bladder, these results offer something rare in oncology: a real chance to preserve both life and quality of life.
Saudi Arabia Took a Bigger Step
While U.S. regulators limited approval to a narrow bladder cancer population, Saudi Arabia took a much broader approach. Saudi regulators cleared Antkiva for both bladder cancer and lung cancer, making it the first country to approve the therapy beyond its original U.S. indication.
This decision signals a willingness to treat Antkiva as a platform immune therapy rather than a single use drug. It also reflects a different regulatory philosophy in areas of high unmet medical need, where early evidence and biological plausibility are weighed more heavily than strict indication boundaries.
Brain Cancer and GBM
The most striking signal for Antkiva’s broader potential comes from early work in glioblastoma, one of the deadliest and most treatment resistant cancers known.
In a small early trial involving patients with recurrent glioblastoma, Antkiva was used as part of a chemotherapy free regimen that included natural killer cell therapy and tumor treating fields. All five patients achieved disease control, with several experiencing near complete responses.
Glioblastoma has long resisted conventional treatments because it suppresses the immune system and thrives in a hostile, heterogeneous tumor environment. Antkiva’s ability to restore immune cell counts and reverse lymphopenia may be key. By rebuilding the immune system itself, the therapy appears to create conditions where immune cells can finally function inside the brain.
The sample size is small, and larger trials are essential. But in a cancer where five year survival is often measured in single digits, even early signals like these are impossible to ignore.
How the Immune Strategy Changes the Cancer Equation
Antkiva works by binding to IL 15 receptors on natural killer cells and CD4 and CD8 T cells. This drives expansion of memory killer T cells without activating suppressive regulatory cells that blunt immune responses.
This distinction matters. Many immune therapies activate the immune system broadly, sometimes triggering exhaustion or autoimmune toxicity. Antkiva is designed to amplify the parts of the immune system that kill cancer while avoiding pathways that shut immune activity down.
Because this immune machinery exists in every tissue, the same mechanism can theoretically be applied across many cancers, regardless of where they originate.
How Much Treatment Costs Today
The cost of Antkiva treatment can be extreme when viewed at list prices today. A single vial of Antkiva is priced at about $35,800 per 400 microgram dose, and the recommended treatment schedule involves multiple doses over many months. A full induction and maintenance course with BCG instillations can theoretically involve 27 or more doses, which at list price would amount to roughly $1.1 million in drug costs alone. Real world drug bills for the first year of treatment often exceed $300,000 before discounts, facility fees, physician fees, imaging, and procedures are included. Out of pocket costs for patients vary widely. Some commercially insured patients may see drug coinsurance reduced to as little as $25 per dose under copay support programs, with annual benefits capped around $25,000, while Medicare Advantage patients can hit annual out-of-pocket maximums in the $7,000–$9,000 range because of coinsurance rules. Uninsured or underinsured patients may qualify for assistance that provides the drug at no charge, but they still face clinic charges and ancillary costs often in the low five figures over time.
At list price, Antkiva is extremely expensive. A single dose is priced at roughly thirty five thousand dollars, and treatment involves multiple doses over months or even years. A full course at list pricing can approach one million dollars for the drug alone.
In practice, real world costs vary widely. Many insured patients reach their annual out of pocket maximum quickly, and commercial copay programs can reduce per dose costs dramatically. Assistance programs also exist for uninsured or underinsured patients. Even so, repeated clinic visits, procedures, imaging, and monitoring create a significant financial burden.
This places Antkiva today in the most expensive tier of modern oncology. Supporters argue this is a temporary phase, typical of early biologic breakthroughs, and that prices will fall as manufacturing scales and broader approvals expand access.
Who Is Patrick Soon Shyung?
The driving force behind Antkiva is Patrick Soon-Shiong, a transplant surgeon, medical researcher, and billionaire entrepreneur. He is best known for developing Abraxane, a widely used cancer drug, and for building a network of biotech and healthcare companies focused on immunology and data driven medicine.
Soon Shyung serves as executive chairman and chief medical and technology officer of ImmunityBio. He has spent decades arguing that cancer is fundamentally an immune failure and that restoring immune competence is the key to long term control.
Why Some See a General Purpose Cancer Therapy Emerging
Antkiva’s approval in bladder cancer is not the end of the story. It may be the beginning.
A therapy that expands natural killer cells, restores immune memory, reverses lymphopenia, and avoids the toxicity of chemotherapy offers something oncology has chased for decades. It offers the possibility of treating cancer as a systemic immune condition rather than a localized mass that must be cut out or poisoned.
Today, Antkiva is expensive and limited by regulatory boundaries. But if its immune engine continues to show results across multiple cancers, the logic becomes difficult to ignore. What begins as a specialized bladder cancer treatment could evolve into a broadly deployed immune platform.
If that happens, cancer treatment would no longer be defined by surgery suites and chemotherapy wards, but by immune restoration. For the first time, that future no longer sounds theoretical.
