Cancer immunotherapy

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Cancer immunotherapy involves treatments that harness the intrinsic mechanisms of the patient's own immune system to trigger a targeted immune response against tumor cells[1]. Having originated from aberrant gene expression and mutations, cancer cells display many non-self antigens from mutant proteins, known as neoantigens, that are specific to the tumor and thus have the potential to be recognized by the immune system[2]. However, most often than not, tumor cells evade immune response by repressing the activities of T-lymphocytes[3]. Targeted immunotherapy treatments, such as adoptive cell transfer and engineered T-cell methods, exploit the cytotoxic T-cells to counteract this evasion[4].

    ACT involves manipulation of the tumor-infiltrating lymphocytes (TILs), tumor-associated lymphocytes that can recognize tumor antigens[5]. The process involves extracting the tumor specimen, selecting the tumor-specific TILs and amplifying them in vitro using growth factors and finally reintroducing the amplified cells plus growth factors into the patient. While this in vitro procedure is being done, the patient is given chemotherapy to eliminate the immune cells that repress the activity of activated T-cells[6]. The adoptive cells can continue to expand using the growth factors after reinfusion, thus the ability to attack cancer cells is maximized[7] There has been promising results in ACT clinical trials in patients with metastatic melanoma, cervical cancer and some blood cancers etc.[8].

    This method involves genetically introducing recombinant T-cell receptors (TCRs) that are specific to antigens on tumor cells[9]. Synthetic TCR gene sequences are "introduced in vitro into patients' normal T-cells, the recombinant cells are then selected, amplified and reinfused into the patient"[10]. Evidence from clinical trials has shown positive results in treating leukemias and lymphomas[11].



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