Cancer Immunotherapy – a New Frontier in Cancer Treatment
This past decade has seen a rapid and dramatic shift in cancer management with the increasingly widespread use of cancer immunotherapy drugs. Immunotherapy is based on the concept of cancer immunosurveillance (1), the idea that a natural function of the immune system includes detection and elimination of transformed host cells, and that by extension, enhancing immune function can amplify antitumor response and aid in eradication of existing cancers and metastases. There are currently several distinct classes of immunotherapeutic drugs, including monoclonal antibody therapy, cytokine therapy, cellular immunotherapy, and antitumor vaccination (2).
Side Effects of Cancer Immunotherapy
The side effects seen with immunotherapy drugs are distinct from those reported with traditional chemotherapy, and requires unique monitoring and treatment. Given that these immunotherapeutic drugs act on the spectrum between anti-tumor and anti-self, it is not surprising that external manipulation of these pathways disrupts the balance of self-tolerance, resulting in high rates of autoimmune toxicity. The study of immune related adverse events and their management is a critical area of immunotherapeutic research, as the development of autoimmune related toxicity often limits the use of these otherwise effective cancer therapeutics.
- Smyth MJ, Dunn GP, Schreiber RD. Cancer immunosurveillance and immunoediting: the roles of immunity in suppressing tumor development and shaping tumor immunogenicity. Adv Immunol. 2006;90:1-50. doi:10.1016/S0065-2776(06)90001-7.
- Granier C, De Guillebon E, Blanc C, et al. Mechanisms of action and rationale for the use of checkpoint inhibitors in cancer. ESMO Open. 2017;2(2):e000213. doi:10.1136/esmoopen-2017-000213.