Tumours: Immunotherapy

Abstract

The mainstay of cancer treatment has historically involved therapies, such as surgery, chemotherapy or radiation, that were developed without regard for the patient's immune system. However, as researchers have started to elucidate mechanisms by which the immune system can eradicate cancerous cells, an increasing number of approaches have been developed that capitalise on an immune‐based antitumour response. These therapies include nonspecific activation of the immune system using toll‐like receptor ligands, cytokines or immune checkpoint inhibitors, or specific treatments, like monoclonal antibody administration or vaccination, that directly target cancer cells. Perhaps, the most promising specific therapy is the adoptive transfer of genetically engineered tumour‐reactive T cells, an approach that has already proven curative in some patients with metastatic disease. Cumulatively, these new immune‐based approaches have great promise to revolutionise cancer therapy. In this article, we will outline the mechanisms and characteristics of these tumour immunotherapies, emphasising those with demonstrated clinical efficacy.

Key Concepts:

  • The immune system can destroy malignant cells.

  • The tumour microenvironment enables tumour growth by exerting immunosuppression.

  • Restoring the immune system's ability to fight cancers is a promising clinical approach.

  • Nonspecific immunotherapies include administration of toll‐like receptor ligands, cytokines or immune‐checkpoint inhibiting antibodies.

  • Specific immunotherapies include administration of monoclonal antibodies, adoptive T cell transfer or vaccination.

Keywords: adoptive transfer; cancer; cytokines; immunotherapy; toll‐like receptors; vaccination

Figure 1.

Generalized scheme of adoptive cell transfer (ACT) of genetically modified T cells. In ACT, T cells from a cancer patient‘s peripheral blood are genetically modified to recognize the tumor ex vivo and reinfused into the patient. Reprinted from January 2013 issue of Progressnotes (MUSChealth.com/progressnotes), with permission of the Medical University of South Carolina. Image by Emma Vought. All rights retained.

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Further Reading

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Johnson, C Bryce, Salem, Mohamed L, Mehrotra, Shikhar, Cole, David J, and Rubinstein, Mark P(Jun 2013) Tumours: Immunotherapy. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0001432.pub3]