Immunotherapy of cancer in 2012 - Kirkwood - 2012 - CA: A Cancer Journal for Clinicians - Wiley Online Library

Immunotherapy of cancer in 2012 - Kirkwood - 2012 - CA: A Cancer Journal for Clinicians

excerpt re: ovarian cancer:

Immunotherapy for Ovarian Cancer

Recent work has shown a correlation between increased survival and the presence of tumor-infiltrating effector-type lymphocytes in a given patient. The absence of tumor- infiltrating regulatory cells has supported the role of immune surveillance in the progression of ovarian cancer and provided additional rationale for immunotherapy for this aggressive disease. 314...............
While attempts using non–antigen-specific treatments of ovarian cancers included the local administration of cytokines and antibodies,314 more recently, several groups initiated vaccination trials involving whole tumor cells,315 either autologous or allogeneic, and tumor cells loaded on autologous DCs316, 317 to provide the immune system with the wide panels of the ovarian carcinoma-specific antigens and to avoid the obstacles related to the unclear ability of the individual OvCa-associated antigens (CA 125, HER-2/neu, folate receptor, or mucin antigen 1 [MUC1]) to serve as common tumor-restricted antigenic targets.318 A clinical trial of DC-enriched PBMCs loaded with HER-2/neu–GM-CSF (lapuleucel-T [APC8024]; Dendreon's product analogous to Provenge) showed modest clinical activity against HER-2/neu–overexpressing tumors, including ovarian cancer, but it remains to be tested whether such a strategy will have survival-prolonging effects analogous to sipuleucel-T for this group of patients.

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Abstract

The immunotherapy of cancer has made significant strides in the past few years due to improved understanding of the underlying principles of tumor biology and immunology. These principles have been critical in the development of immunotherapy in the laboratory and in the implementation of immunotherapy in the clinic. This improved understanding of immunotherapy, enhanced by increased insights into the mechanism of tumor immune response and its evasion by tumors, now permits manipulation of this interaction and elucidates the therapeutic role of immunity in cancer. Also important, this improved understanding of immunotherapy and the mechanisms underlying immunity in cancer has fueled an expanding array of new therapeutic agents for a variety of cancers.
Pegylated interferon-α2b as an adjuvant therapy and ipilimumab as therapy for advanced disease, both of which were approved by the United States Food and Drug Administration for melanoma in March 2011, are 2 prime examples of how an increased understanding of the principles of tumor biology and immunology have been translated successfully from the laboratory to the clinical setting. Principles that guide the development and application of immunotherapy include antibodies, cytokines, vaccines, and cellular therapies. The identification and further elucidation of the role of immunotherapy in different tumor types, and the development of strategies for combining immunotherapy with cytotoxic and molecularly targeted agents for future multimodal therapy for cancer will enable even greater progress and ultimately lead to improved outcomes for patients receiving cancer immunotherapy..........