State-of-the-art immunotherapies may show great promise in the future for cancer treatment.
Immunotherapy research results show that cancer treatment may need a combination approach. Dr. Andrew S. Chi, the chief of neuro-oncology and the codirector of the Brain Tumor Center at NYU Langone, weighed in on the state of developed immunotherapy approaches. A number of strategies involve increasing T-cell activation against tumors by the use of checkpoint inhibitors (that block proteins that inhibit immune system attack of cancer cells). Dr. Chi points out that combinations of immune checkpoint inhibitors may be more effective.
Chimeric Antigen Receptor T cell (CAR-T) therapy is another emerging and promising approach to anticancer immunotherapy. The use of CAR-T cells allows the use of the patient’s own immune system to attack cancer cells. In one patient that received CAR-T therapy against a specific interleukin (IL-13R), a remarkable antitumor response was observed. However, there are still limitations to widespread use because a target must be present on all tumor cells to prevent a tumor cell from repopulating. Also, if the target is also present on normal cells, adverse effects may occur. One concern that Dr. Chi expressed is the intratumoral heterogeneity of glioblastoma. Therefore, identifying a target or marker expressed on all tumor cells would make the use of CAR-T a more powerful immunotherapy approach.
The use of antibody-drug conjugates is another type of immunotherapy, including for glioblastoma. One example is an antibody-drug conjugate against epidermal growth factor, a surface protein overexpressed in most, but not all, glioblastomas. As with CAR-T, it is important that a surface marker is present in the majority of tumor cells. Using dendritic cell vaccines is yet another immunotherapy strategy. This approach is based on the use of an individual’s own dendritic cells to mount an attack on telomerase, which is expressed in most cancers, although rare (or absent) in normal adult cells.
Dr. Chi said that a possible next step may be to combine immune checkpoint inhibitors with dendritic cells to increase dendritic cell vaccine efficacy. This and the other strategies discussed represent state-of-the-art immunotherapies that may show great promise in the future for cancer treatment. Additional clinical trials will help to determine the best and most effective approaches.
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GBM Emerging Strategies in Immunotherapy. (2018). OncLive. Retrieved 27 March 2018, from http://www.onclive.com/inside-oncology/gbm-immunotherapy-approaches/gbm-emerging-strategies-in-immunotherapy