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 tumour 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 a tumour and thus have the potential to be recognized by the immune system[2]. However, most often than not, tumour 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].

Adoptive cell transfer (ACT)

ACT involves manipulation of the tumour-infiltrating lymphocytes (TILs), tumour-associated lymphocytes that can recognize tumour antigens[5]. The process involves extracting the tumour specimen, selecting the tumour-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 have been promising results in ACT clinical trials in patients with metastatic melanoma, cervical cancer and some blood cancers etc. [8].

Genetically engineered T-cells

This method involves genetically introducing recombinant T-cell receptors (TCRs) that are specific to antigens on tumour 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 leukaemias and lymphomas[11].

References

  1. What is Immunotherapy. Cancer Research Institute. [cited 08/12/2018]. Available from: https://www.cancerresearch.org/immunotherapy/what-is-immunotherapy
  2. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  3. Newman T. How does cancer evade the immune system? New mechanism revealed. Medical News Today. MediLexicon International; 2017 [cited 09/10/2018]. Available from: https://www.medicalnewstoday.com/articles/320177.php
  4. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  5. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  6. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  7. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  8. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  9. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  10. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
  11. Klug WS, Cummings MR, Spencer CA, Palladino MA, Killian D. Concepts of genetics. 12th ed. Hoboken, New Jersey: Pearson Education; 2018.
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