Engineering Organ-on-a-Chip Systems for Cancer Immunotherapy: Strategies and Assay Integration

Translating preclinical findings into effective clinical cancer immunotherapies remains a major challenge, mainly because conventional in vitro and animal models often fail to capture the complexity, dynamics, and species-specific features of human immune responses. Organ-on-a-chip (OoC) technologies that combine engineered tissue architectures with precisely controlled microfluidic transport provide human-relevant microphysiological platforms for mechanistic studies of immune–tumor interactions and evaluation of therapeutic efficacy and immunotoxicity under defined microenvironmental conditions. However, immune responses involve time-dependent and interconnected processes, including immune cell trafficking, cytokine programs, metabolic shifts, and cytolysis, that are not adequately resolved by static or endpoint assays. Engineering immune-competent OoC systems therefore requires coordinated design of platform architectures, immune cell incorporation strategies, and integrated measurement workflows capable of capturing dynamic and state-dependent responses. In this review, we summarize engineering strategies for building immune-competent OoC platforms for cancer immunotherapy, focusing on platform architectures, immune cell incorporation methods, and fit-for-purpose assay workflows. Emphasis is placed on embedded sensing modalities (e.g., cytokine, oxygen, and impedance readouts) that provide valuable kinetic and state-variable data. Finally, we discuss key translational challenges, including reproducibility, standardization, and benchmarking, and outline near-term priorities to accelerate the adoption of immune-competent OoC systems in immunotherapy research and development.