Immunotherapy of cancer

As a concept, immunotherapy seems to be an ideal option for cancer therapy: using the body’s own defences to fight and destroy abnormal, cancerous cells. Now, after years of slow progress, clinical trials are finally producing some exciting results, with some of them demonstrating increased survival for patients with metastatic disease.

Article extracted from the ESMO 2014 onsite newspaper.

“We are seeing encouraging responses in patients”, commented Dr George Coukos from the Centre Hospitalier Universitaire Vaudios, Lausanne, Switzerland. Indeed, last year Science labelled immunotherapy as the science advance of the year.

“We now have a number of approved immunotherapeutics, with several more in advanced development. In my opinion, this is one of the most exciting fields to be working in,” added Dr Coukos.

A major breakthrough has been the development of checkpoint inhibitors – typically monoclonal antibodies that block the activity of immunosuppressive ligands released by many cancer cells. For example, nivolumab inhibits the binding between the T cell receptor PD-1 and its ligands, thereby preventing T cell differentiation. In the phase II CheckMate-010 trial of nivolumab for renal cell carcinoma in patients receiving up to 3 prior therapies (including at least one vascular endothelial growth factor-targeting agent), 20–22% of patients responded and the median overall survival was 18.2 months. (1)

The cancer vaccine sipuleucel-T won approval from the FDA in 2010 as the first ever therapeutic vaccine for cancer.(2) The treatment harvests leukocytes from a patient and incubates them with a fusion protein made up of prostatic acid phosphatase and granulocyte-macrophage colony stimulating factor (GM-CSF). This activates the patient’s immune cells, which are reinfused to trigger an immune response against cancer cells.

Another recent immunotherapeutic approach under investigation is the exploitation of tumour infiltrating lymphocytes (TILs). A process called adoptive cell therapy essentially grows quantities of TILs from a patient’s tumour for reinfusion to boost the antitumour immune response.

“Immunotherapy will add to the treatment armamentarium for many cancer patients, especially in kidney and non-small-cell lung cancers and melanoma, where slow growth favours the immunological approach,” said ESMO 2014 Congress President Professor Rolf Stahel from the University Hospital Zürich, Switzerland. “It is crucial that oncologists stay abreast of these advances.”

In addition to precision medicine, immunotherapy is also a focus of the ESMO 2014 congress.

In 2013 ESMO held its first Immuno-Oncology Symposium. The symposium was a resounding success, with oncologists coming from across Europe learned about recent clinical advances, including trial updates on drug combinations and sequences. The ESMO Symposium on Immuno-Oncology 2014 will take place again this year in Geneva, Switzerland.  

References

1.     Motzer RJ, et al. J Clin Oncol 2014;32(Suppl 5s): Abstract 5009
2.      http://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ApprovedProducts/ucm210215.htm