2016 May | Danny N. Khalil, Eric L. Smith, Renier J. Brentjens, and Jedd D. Wolchok
The future of cancer treatment involves immunomodulation, CARs, and combination immunotherapy. Recent advances in monoclonal antibodies (mAbs) and adoptive cellular therapy have led to significant responses in patients with advanced-stage cancers. Three immune-checkpoint-blocking mAbs are already approved for various cancers, and more patients are expected to benefit from immunomodulatory mAb therapy. Adoptive transfer of genetically modified lymphocytes has shown dramatic results in treating hematological malignancies and is expected to become the standard of care for more patients.
Immunotherapy involves generating or augmenting an immune response against cancer. It has been studied for over a century but only in the past decade has shown consistent improvements in overall survival in phase III trials. Antitumour immunotherapy has broad potential and can treat many advanced-stage cancers due to its durable and robust responses. Two effective immunotherapies are immune-cell-targeted mAbs and adoptive cellular therapy (ACT). Current clinical progress in both modalities is discussed, along with their potential therapeutic relevance in combination regimens.
Monoclonal antibodies targeting immune cells can modulate T-cell function and lead to tumour regression. Immunotherapy can generate immunological memory, which helps prevent disease recurrence and guard against therapy-resistant malignant clones. Evidence shows durable remissions in some patients with melanoma. T-cell-stimulatory therapy can lead to tumour regression, highlighting the robustness of immunotherapy responses compared to traditional treatments.
Checkpoint blockade, targeting CTLA-4 and PD-1, has shown promise in cancer immunotherapy. Anti-CTLA-4 mAbs have been used in clinical trials to enhance immune responses. PD-1 and PD-L1 blockade are among the most promising clinical endeavours, with several mAbs approved for melanoma and NSCLC. Combination therapies, such as anti-CTLA-4 and anti-PD-1, have shown significant promise in clinical trials.
Other immune-checkpoint receptors, such as LAG-3, TIM-3, and TIGIT, are also being investigated for their potential in immunotherapy. Co-stimulation of T-cells through agonist mAbs targeting co-stimulatory receptors like 4-1BB, GITR, CD40, and OX40 has shown promising results in preclinical studies. These approaches aim to enhance T-cell activation and improve antitumour responses.
CAR-T-cell therapy involves modifying T-cells to target cancer cells. CD19-targeted CAR-T-cell therapy has shown remarkable success in treating B-cell acute lymphoblastic leukaemia (B-ALL) and other B-cell malignancies. Clinical trials have demonstrated high response rates and durable remissions. However, challenges remain in optimizing CAR-T-cell design, conditioning regimens, and managing toxicity.
Combination therapies involving checkpoint blockade and co-stimulation are being explored to enhance antitumour responses. CAR-T-cell therapy is being evaluated inThe future of cancer treatment involves immunomodulation, CARs, and combination immunotherapy. Recent advances in monoclonal antibodies (mAbs) and adoptive cellular therapy have led to significant responses in patients with advanced-stage cancers. Three immune-checkpoint-blocking mAbs are already approved for various cancers, and more patients are expected to benefit from immunomodulatory mAb therapy. Adoptive transfer of genetically modified lymphocytes has shown dramatic results in treating hematological malignancies and is expected to become the standard of care for more patients.
Immunotherapy involves generating or augmenting an immune response against cancer. It has been studied for over a century but only in the past decade has shown consistent improvements in overall survival in phase III trials. Antitumour immunotherapy has broad potential and can treat many advanced-stage cancers due to its durable and robust responses. Two effective immunotherapies are immune-cell-targeted mAbs and adoptive cellular therapy (ACT). Current clinical progress in both modalities is discussed, along with their potential therapeutic relevance in combination regimens.
Monoclonal antibodies targeting immune cells can modulate T-cell function and lead to tumour regression. Immunotherapy can generate immunological memory, which helps prevent disease recurrence and guard against therapy-resistant malignant clones. Evidence shows durable remissions in some patients with melanoma. T-cell-stimulatory therapy can lead to tumour regression, highlighting the robustness of immunotherapy responses compared to traditional treatments.
Checkpoint blockade, targeting CTLA-4 and PD-1, has shown promise in cancer immunotherapy. Anti-CTLA-4 mAbs have been used in clinical trials to enhance immune responses. PD-1 and PD-L1 blockade are among the most promising clinical endeavours, with several mAbs approved for melanoma and NSCLC. Combination therapies, such as anti-CTLA-4 and anti-PD-1, have shown significant promise in clinical trials.
Other immune-checkpoint receptors, such as LAG-3, TIM-3, and TIGIT, are also being investigated for their potential in immunotherapy. Co-stimulation of T-cells through agonist mAbs targeting co-stimulatory receptors like 4-1BB, GITR, CD40, and OX40 has shown promising results in preclinical studies. These approaches aim to enhance T-cell activation and improve antitumour responses.
CAR-T-cell therapy involves modifying T-cells to target cancer cells. CD19-targeted CAR-T-cell therapy has shown remarkable success in treating B-cell acute lymphoblastic leukaemia (B-ALL) and other B-cell malignancies. Clinical trials have demonstrated high response rates and durable remissions. However, challenges remain in optimizing CAR-T-cell design, conditioning regimens, and managing toxicity.
Combination therapies involving checkpoint blockade and co-stimulation are being explored to enhance antitumour responses. CAR-T-cell therapy is being evaluated in