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Anti-cancer strategies

Anti-cancer strategies

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Anti-cancer strategies -

In many cancers, little or no anti-cancer immunity exists in patients that manifests as cold tumors with little immune cell infiltration at the tumor sites. These cold tumors usually do not respond to ICBs, as there is no ammunition to fire at cancer cells upon removal of the brake by ICBs.

To improve their efficacy, cancer vaccines have been extensively studied to be combined with adjuvant agents, such as a TLR-3 agonist poly-ICLC, to stimulate immune response. Many trials are currently ongoing to determine the efficacy and toxicity of cancer vaccines in combination with cytokines.

For example, IL-2 plays critical roles in key functions of immune response. In addition to IL-2, several other immunostimulatory cytokines are being explored.

IL is a multipotent cytokine that stimulates T and NK cells, regulates other cytokines and multiple aspects of immune response. Several clinical trials are currently ongoing to determine the efficacy and toxicity of IL and cancer vaccine combinations.

Extensive preclinical studies as well as many clinical trials are currently ongoing to combine cancer vaccines with ICBs. GXE tirvalimogene teraplasmid is a therapeutic HPV DNA vaccine that encodes HPV and HPV E6 and E7 [ ].

This combination was well tolerated [ ]. Other than concurrent use, ICB has also been shown to have activity as a salvage therapy after cancer vaccine failure.

Ott et al. showed that pembrolizumab induced complete responses in melanoma patients after failure of treatment with synthetic long peptide vaccine of tumor neoantigens with poly-ICLC adjuvant [ ]. With a follow-up of almost four years, long-term persistence of neoantigen-specific T cells was still observed with the development of memory T cell phenotype, tumor infiltration and epitope spreading [ ].

One Phase I clinical trial has already been reported with a melanoma-associated antigen recognized by T cells 1 MART-1 peptide vaccine plus IMP, a fusion protein consisting of four LAG-3 extracellular Ig-like domains fused to the Fc fraction of a human IgG1 LAG-3Ig.

A few combination therapies have been approved by the FDA to improve clinical efficacy of ICIs. With increasing research in identifying action-driven reliable biomarkers in guiding clinical immuno-oncology decisions, IO combinations among ACT, novel ICIs, cancer vaccines and small molecule inhibitors are expected.

In this regard, the future of cancer immunotherapy awaits for a truly patient-oriented, individualized approach. Li Z, Song W, Rubinstein M, Liu D. Recent updates in cancer immunotherapy: a comprehensive review and perspective of the China Cancer Immunotherapy Workshop in Beijing. J Hematol Oncol.

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Show more related content. As with any treatment, however, there are still associated risks that should be discussed with your doctor. Once treatment begins, monitoring is key.

More monitoring and follow-up occur with immunotherapy than with most other forms of treatment. You will likely undergo testing to allow your doctor to evaluate how well treatment is working by measuring the size of the tumor as treatment progresses.

Several different immunotherapy strategies are currently being studied or used as cancer treatments, including the following. There are two main types of adoptive cell transfer immunotherapy.

In the second strategy, T-cells collected from the patient are engineered with new receptors chimeric antigen receptor T-cells, or CAR-T to recognize specific antigens on the surface of cancer cells, and then infused back into the patient. In both cases, the T-cells multiply, seek and destroy the cancer cells that carry those specific antigens.

This type of immunotherapy is still investigational and available only through clinical trials. Studies have shown promise in the treatment of leukemia, lymphoma, metastatic melanoma, neuroblastoma and synovial cell sarcoma.

Immune checkpoint pathways are specific connections between molecules on the surfaces of immune cells — specifically between antigen-presenting cells and T-cells, or between T-cells and tumor cells — that help regulate the immune response.

Some tumor cells have proteins on their surface that bind to activated immune cells and inhibit their function. This connection effectively puts the brakes on the attack known as tumor-induced immunosuppression. Immune checkpoint inhibitors are drugs that block the checkpoint from being engaged, which essentially turns the immune response back on.

These immune checkpoint inhibitors currently are being used to treat cancer. Some antibodies can recognize portions of proteins on the surface of cancer cells. Researchers can design antibodies that specifically target a certain antigen. Monoclonal antibodies mAbs are antibodies made in a laboratory that are designed to target specific tumor antigens.

Also, mAbs can work in different ways, such as flagging targeted cancer cells for destruction, blocking growth signals and receptors or delivering other therapeutic agents directly to targeted cancer cells.

They also can be created to carry cancer drugs, radiation particles or laboratory-made cytokines proteins that enable cells to send messages to each other directly to cancer cells see Figure 1.

When a mAb is combined with a toxin, such as a chemotherapy drug, it travels through the system until it reaches the targeted cancer cell, where it attaches to the surface, gets swallowed by the tumor cell and breaks down inside the cell, releasing the toxin and causing cell death.

Combining mAbs with radiation particles, a treatment known as radioimmunotherapy, allows for radiation to be delivered in lower doses over a longer period of time directly to specific cancer cells. This direct form of radiation delivery typically damages only the targeted cells.

This immunotherapy strategy gives the immune system an overall boost and can be used alone or in combination with other treatments to produce increased and longer-lasting immune responses. Different types of nonspecific immune stimulation include the following. One treatment strategy uses viruses to attack cancer.

Oncolytic virus immunotherapy involves the use of viruses to directly infect tumor cells and induce an immune response against the infected cells.

With one of the most-studied approaches, a modified, weakened version of the herpes simplex virus that also contains the cytokine GM-CSF is used. The virus targets specific cancer cells, infects them and duplicates itself continuously within the cell until it ruptures. This rupture kills the cell and releases the GM-CSF protein induced by the virus to promote an overall immune boost against the cancer.

This process increases the chance that the attack can also begin killing cancer cells that have not been infected with the virus.

Although researchers have been trying to develop vaccines to fight cancer for many years, knowledge gained in recent years is improving this treatment approach. Vaccines against cancer are created from either modified viruses or tumor cells and are designed to direct immune cells to the cancer cells.

There are two types of cancer vaccines: prophylactic vaccines, which prevent the viruses that cause cancers, and therapeutic vaccines, which treat existing cancers.

Currently, prophylactic vaccinations are available for human papillomavirus HPV , the cause of many cervical, anal, and head and neck cancers, and hepatitis B virus HBV , a known risk factor for liver cancer. This website uses cookies to deliver to you the best experience possible on SITC CONNECT.

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Author: Dailabar

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