Active Immunotherapy in cancer – Current Status by Bakulesh Khamar in Novel Approaches in Cancer Study
Immunotherapy is a fourth pillar in cancer management after surgery,
radiotherapy and chemotherapy. Active immunotherapy works by inducing
antigen specific immune response following its administration while
checkpoint inhibitor works by reducing tumor induced immunosuppression
and
thereby utilizing pre-existing immune response. Adoptive cell therapy
(ACT) is a type of personalized therapy wherein cells are harvested from
a
patient, expanded and reintroduced. The T cells are genetically modified
in chimeric antigen receptor T cell (CAR-T) therapy while tumor
infiltrating
cells are used in in ACT and dendritic cells are used in dendritic cell
(DC) vaccine. Vaccine induces T cell response against the antigen of
interest. T
cells available following single administration are higher in ACT
compared to vaccine approach. CAR-T cells are found useful in refractory
large B-celllymphoma and refractory large B-cell precursor acute lymphoblastic
leukemia. ACT is found useful in melanoma. Vaccines are approved for
melanoma
as a monotherapy and for non-small cell lung cancer in combination with
chemotherapy.
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