Type of paper:Â | Article review |
Categories:Â | Medicine Pharmacology Cancer Drug |
Pages: | 6 |
Wordcount: | 1531 words |
Within the last century, cancer immune escape has undergone a significant evolution. Ranging from the past, present, and into the future, cancer treatment has significantly moved from mere immune checkups to vaccines. Vinay, Ryan, Pawelec, Talib, Stagg, Elkord, and Signori (2015) noted that cancer cells have multiple mechanisms that they use to evade immune surveillance which increases their potential to survive. Conventional treatments have deadly side effects and the stimulation of the immune system is evidenced as the most sustainable approach to treating cancer. This article review will conduct a review of multiple articles on the cancer immune escape developments, strategies, and future possibilities in the use of immunity in combating cancerous cells.
According to an article by Osipov, Murphy, and Zheng, (2019), they outline that the evolution of cancer immunotherapy involves the utilization of the best treatment modalities as well as achieving long-term responses. In the article, Osipov et al. (2019) highlighted the existence of a fundamental gap in the understanding of cancer immune escape. In the article, they reveal the intricate relationship between the tumours and immune system. Precisely, the report delivers that there has been progressing with the approval of over ten immune escape agents such as vaccine-based therapies, oncolytic viruses, checkpoint inhibitors, and other T cell therapies providing more than twenty different indications across countless tumour types. In other cases, the understanding whereby the immune system has been able to peer into the cancer-immune scape has paved a gateway for the study and development of the immune system altering therapies and agents (Osipov, Murphy, & Zheng, 2019).
Vinay et al. (2015) points out strategies such as the vaccination with DCs, viral based vectors and the immunotherapy using the autoreactive effector cells amongst the futuristic avenues of treating cancer. Besides, studies have also shown that bacteria administration also increases cancer immunogenicity. Vinay et al. (2015) adds the use of targeted immunosuppression using mediators that are soluble as an avenue through which futuristic cancer immunotherapy will be developed. According to Vanichapol, Chutipongtanate, Anurathapan, and Hongeng (2018) the mechanism of immune evasion involves the infiltration of the immunosuppressive cells in the neuroblastoma which is instrumental in the mediation of antitumor immunity and reduces cancer growth. Vanichapol et al. (2018) shows that overcoming the immunosuppressive tumor is necessary in the development of the immunotherapeutic approach for cancer treatment. One of the suggested approaches is the use of genetically engineered Tlymphocytes which are directed against the CAR Tcells and enables the T cells to recognize the TAAs. They add that the CAR T cell trafficking and accumulation in the cancerous cells is instrumental in promoting optimum antitumor response with the regional delivery of CAR T cells being used to prevent poor cell trafficking to the tumor cells.
According to an article by Liu and Guo (2018), they highlight recent advancements of the immunotherapy approaches. In the report, Liu and Guo (2018), noted that there had been significant updates on cancer immunotherapy ranging from traditional cancer therapies such as chemotherapy, radiation, and surgery. As immunotherapy seeks to help the immune systems fight cancer, Liu and Guo (2018), provide information on the recent approval of immune checkpoint inhibitors and T lymphocytes that express chimeric antigen receptors (CAR T) by the FDA signifying the unprecedented progress. Further, the article provides new mechanisms of cancer immune evasion outlining how tumour cells evade immune responses, as shown in the slide below.
Primarily, the researchers provide details on the various immunotherapy drugs recently approved by the FDA, such as CD19 CAR T and the immune checkpoint inhibitors anti-PD-1/PD-L1/CTLA-4 (Liu & Guo, 2018).
Correspondingly, there has been significant progress with the increased knowledge on the relationship between cancer and the immune system. In the revolutionization of the traditional cancer treatment methods, adoptive cancer therapy and immune checkpoint therapies have played a vital role in signifying the latest progress. According to Zhang and Chen's (2018) article, they focus on the current cancer immunotherapy strategies clarifying that cancer immunotherapy is becoming an attractive strategy among various therapeutic options. The primary goal for the article was to summarize the molecular bases of the immune system as well as the relationship with cancer and recent developments in cancer immune escape. In the article, Zhang and Chen (2018) clarify the different growths in the cancer-immune escape by pointing out the developments such as chimeric antigen receptor (CAR) T-cell therapy and cancer vaccination. Further, Zhang and Chen (2018) show the critical events in cancer immunotherapy history.
In other events, immunotherapy has encountered various shifts in treating numerous advanced tumors. The cancer immune escape has tremendously developed with the involvement of clinical responses serving as checkpoint inhibitors. According to Saung, Osipov, Zheng, and Murphy (2019), they provide details on tumour microenvironment and offer the various ways of overcoming immune escape. According to the article, many tumours are less responsive to multiple checkpoint inhibitors. Saung et al. (2019), delivers details on the latest progress stating that immunotherapy has developed becoming a primary pillar of the oncologic care. With the direct relationship between immune evasion and tumor growth, they represent a general rule by governing the different pathological cancer system. According to Nicolini et al. (2018), the present progress in the cancer-immune escape by reviewing the recent experimental and clinical information to propose innovative therapeutic strategies for advanced cancer immune escape.
According to Fares, Van Allen, Drake, Allison, and Hu-Lieskovan (2019), the emergence of the checkpoint blockade therapies in the last decade has led to the transformation of cancer treatments with significant clinical response in a large number of tumor types. The immune checkpoint inhibitors have long-term therapeutic effect on tumors that are difficult to treat and involves learning and understanding the resistance mechanism of the immune checkpoint blockade with the immune checkpoint inhibitors being progressively creates and tested in clinical trials although some are already in use in the treatment of cancer (Bouffet, Larouche, Campbell, Merico,... & Zhukova, 2016). The immune checkpoint inhibitors have acquired certification for use through the approval of the U.S Food and Drug Administration. These include; three PD-L1 inhibitors, one CTLA- 4 inhibitor and PD-1 inhibitors. In 2012, the FDA gave approval to the Iplumumab which became the first immune checkpoint inhibitor to receive approval and it is used in the treatment of melanoma. The continued research and use of immunotherapy stems from their response durability which is instrumental towards the survival of cancer patients. However, the response to the immune checkpoint inhibitors depends on the turmor proportional burden. Fares et al. (2019) argues that the increase in the tumor immunogenicity and T-cell priming can be used in immune checkpoint blockade inhibitors treatments to prevent the resistance of cancerous cells. These strategies which involves the use of anti-CTLA-4 and anti-PD-1 are already in use in the treatment of various cancer types such as renal cell carcinoma, colorectal cancer, and melanoma.
Conclusion
There are many promising immune escape approaches of cancer cells treatment. The immune therapy strategies have a superior advantage in that they last longer and have less side effects compared to the conventional chemotherapy and radiation treatment approaches. The immune checkpoint inhibitors, the use of tumor immunogenicity, T cell priming, infiltration of the immunosuppressive cells, viral based vectors, and immunotherapy using the autoreactive effector cells are amongst avenues of immune escape that are already in clinical trials and some in use to overcome cancerous cells. The use of immune escape in fighting cancer cells is promising and will be instrumental in the treatment of tumors in the near future.
References
Bouffet, E., Larouche, V., Campbell, B. B., Merico, D., De Borja, R., Aronson, M., Zhukova, N. (2016). Immune checkpoint inhibition for hypermutant glioblastoma multiforme resulting from germline biallelic mismatch repair deficiency. Journal of clinical oncology, 34(19), 2206-2211. Retrieved from https://profiles.wustl.edu/en/publications/immune-checkpoint-inhibition-for-hypermutant-glioblastoma-multifo
Fares, C. M., Van Allen, E. M., Drake, C. G., Allison, J. P., & Hu-Lieskovan, S. (2019). Mechanisms of Resistance to Immune Checkpoint Blockade: Why Does Checkpoint Inhibitor Immunotherapy Not Work for All Patients? American Society of Clinical Oncology Educational Book, 39, 147-164. Retrieved from https://ascopubs.org/doi/10.1200/EDBK_240837
Liu, M., & Guo, F. (2018). Recent updates on cancer immunotherapy. Precision clinical medicine, 1(2), 65-74. DOI:10.1093/pcmedi/pby011
Nicolini, A., Ferrari, P., Rossi, G., & Carpi, A. (2018). Tumour growth and immune evasion as targets for a new strategy in advanced cancer. Endocrine-related cancer, 1(aop). DOI:10.1530/ERC-18-0142
Osipov, A., Murphy, A., & Zheng, L. (2019). From immune checkpoints to vaccines: The past, present and future of cancer immunotherapy. Advances in cancer research, 143, 63-144. DOI: 10.1016/bs.acr.2019.03.002
Saung, M. T., Osipov, A., Zheng, L., & Murphy, A. G. (2019). Small molecule immunomodulation: the tumour microenvironment and overcoming immune escape. Journal for immunotherapy of cancer, 7(1), 224. Retrieved from https://link.springer.com/article/10.1186/s40425-019-0667-0
Vanichapol, T., Chutipongtanate, S., Anurathapan, U., & Hongeng, S. (2018). Immune escape mechanisms and future prospects for immunotherapy in neuroblastoma. BioMed research international, 2018. Retrieved from https://www.hindawi.com/journals/bmri/2018/1812535/abs/
Vinay, D. S., Ryan, E. P., Pawelec, G., Talib, W. H., Stagg, J., Elkord, E., Signori, E. (2015, December). Immune evasion in cancer: Mechanistic basis and therapeutic strategies. In Seminars in cancer biology (Vol. 35, pp. S185-S198). Academic Press. Retrieved from https://www.sciencedirect.com/science/article/pii/S1044579X1500019X
Zhang, H., & Chen, J. (2018). Current status and future directions of cancer immunotherapy. Journal of Cancer, 9(10), 1773. DOI: 10.7150/jca.24577
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