Module 3- Immunotherapy and Cancer Vaccines

Question 1

Cancer immunoediting role in evading the immune system- ELIMINATION

Answer 1

Question 2

Cancer immunoediting role in evading the immune system- EQUILIBRIUM

Answer 2

Question 3

Cancer immunoediting role in evading the immune system- ESCAPE

Answer 3

Question 4

So, the natural question is…

Answer 4

Can we use this potential to
engineer and develop the immune system into effective therapies to fight cancer?

Question 5

Unleashing the power of the immune system to defeat cancer- 4 types of cancer immunotherapy

Answer 5

Immunotherapy mobilizes the body’s own natural defense system to fight diseases and is revolutionizing the way cancer is treated.

Question 6

What are immunomodulators?

Answer 6

• Substances that can help support immune
  function by modifying, generally in a beneficial way, the immune system’s response to a threat
• Immunomodulators act as the gas and breaks of the immune system

Question 7

Complexity of the immune system

Answer 7

This sounds simple until you see how integrated an immune response is

Question 8

Immunomodulator targets relevant to the immune response to cancer

Answer 8

Immunomodulator targets can be characterized as checkpoint inhibitors, cytokines, adjuvants.

Question 9

Checkpoint inhibitors

Answer 9

Question 10

Checkpoint inhibitors such as PD-1/PDL-1 and CTLA-4 are among the most understood

Answer 10

Question 11

Checkpoint inhibitors such as PD-1/PDL-1 and CTLA-4 are among the most understood- full picture

Answer 11

Question 12

FDA approved checkpoint inhibitors

What are they used to treat?

Answer 12

Used to treat a range of
cancer including melanoma,
lung, kidney, liver, bladder,
cervical, and colorectal
cancer.

Question 13

Keytruda highlights the importance combining personalized medicine and immunotherapy

Answer 13

https://www.youtube.com/watch?v=tPbMJe5xxgE

Question 14

The use of immunomodulators extends beyond therapeutic uses for cancer

Answer 14

Research has shown that there is a complex immune response in most individuals, and even a severe cytokine storm in some so it is no surprise that a diverse group of immunomodulators are being investigated

Question 15

Engineering Oncolytic Virus to Target Cancer

Answer 15

Question 16

Oncolytic viruses represent a promising approach to treating cancer for several reasons:

Answer 16

1. Cancer cells often have impaired antiviral defenses that make them susceptible to infection.
2. These natural viruses can be engineered to give them advantageous properties, including decreasing their ability to infect healthy cells as well as granting them the ability to deliver therapeutic payloads specifically to tumors and produce immune-boosting molecules once they infect tumor cells.
3. After infection, these oncolytic viruses can cause cancer cells to “burst”—killing the cancer cells and releasing cancer antigens. These antigens can then stimulate immune responses that can seek out and eliminate any remaining tumor cells nearby and potentially anywhere else in the body.

Question 17

Oncolytic Viruses target cancer cells

Answer 17

Question 18

Oncolytic virus platforms used in clinical trials include:

Answer 18

Question 19

T-VEC

Answer 19

• The first oncolytic virus to receive FDA approval was a treatment for melanoma known as talimogene laherparepvec (Imlygic®), or T-VEC
• T-VEC has a two phase mechanism, consisting of primary ablation and secondary tumor-specific immune response

Question 20

How can cancer vaccines be classified?

Answer 20

As preventative, therapeutic, or personalized

Question 21

Preventative cancer vaccines

Answer 21

• Viral infections are responsible for the development of several cancers and preventive vaccines play an important role in reducing risk.
• Four of these preventive cancer vaccines have been approved by the U.S. Food and Drug Administration (FDA).

Question 22

Therapeutic cancer vaccine

Answer 22

• A therapeutic cancer vaccine is a vaccine which is administered after the cancer has already occurred.
• The therapeutic vaccine works by activating immune system of the patient to fight towards the already developed cancer

Question 23

Personalized cancer vaccines

Answer 23

Personalized cancer vaccines, also termed neoantigen vaccines create an immune response directed precisely against patients’ unique antigens on their tumor cells while sparing their healthy cells from immune attack, thus possibly preventing side effects.

Question 24

Cancer vaccine targets relevant to the immune response to cancer

Answer 24

Question 25

What can therapeutic cancer vaccines be based on?

Answer 25

Therapeutic cancer vaccines can be cell-based, protein based, or
nucleic acid based

Question 26

There are two FDA approved therapeutic vaccines- Sipuleucel-T (Provenge®):

Answer 26

Question 27

There are two FDA approved therapeutic vaccines- Bacillus Calmette-Guérin (BCG):

Answer 27

Bacillus Calmette-Guérin (BCG): a vaccine that uses weakened bacteria to stimulate the immune system; approved for patients with early-stage bladder cancer

Question 28

What are neoantigens?

Answer 28

• Neoantigens (“new antigens”) are antigens exclusive to tumor cells and not by healthy cells
• With neoantigen vaccines,
  therefore, it is conceivable that immune responses could be directed precisely against patients’ tumor cells while sparing their healthy cells from immune attack, thus possibly
  preventing side effects

Question 29

Combination of therapies to treat cancer

Answer 29