No, very much not possible to miniaturize, imo. At least without someone skilled in the black magic of cellular RF design. And the time of those that are skilled in it, I believe is way too valuable to them to spend their time on this. Which is also the reason a 5G card is unlikely at this point in time. I edited my post to comment on the 5G part,
in case you missed it.
The picture of the board he posted looks to me to have not one millimeter of length wasted. The connectors are placed right up against the module. LTE modules are just too long. Honestly, we are lucky they even fit at all! If they were a couple millimeters wider, it wouldn’t fit inside at all.