Module 3- Immunotherapy and Cancer Vaccines Flashcards
Cancer immunoediting role in evading the immune system- ELIMINATION
Cancer immunoediting role in evading the immune system- EQUILIBRIUM
Cancer immunoediting role in evading the immune system- ESCAPE
So, the natural question is…
Can we use this potential to
engineer and develop the immune system into effective therapies to fight cancer?
Unleashing the power of the immune system to defeat cancer- 4 types of cancer immunotherapy
Immunotherapy mobilizes the body’s own natural defense system to fight diseases and is revolutionizing the way cancer is treated.
What are immunomodulators?
- 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
Complexity of the immune system
This sounds simple until you see how integrated an immune response is
Immunomodulator targets relevant to the immune response to cancer
Immunomodulator targets can be characterized as checkpoint inhibitors, cytokines, adjuvants.
Checkpoint inhibitors
Checkpoint inhibitors such as PD-1/PDL-1 and CTLA-4 are among the most understood
Checkpoint inhibitors such as PD-1/PDL-1 and CTLA-4 are among the most understood- full picture
FDA approved checkpoint inhibitors
What are they used to treat?
Used to treat a range of
cancer including melanoma,
lung, kidney, liver, bladder,
cervical, and colorectal
cancer.
Keytruda highlights the importance combining personalized medicine and immunotherapy
https://www.youtube.com/watch?v=tPbMJe5xxgE
The use of immunomodulators extends beyond therapeutic uses for cancer
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
Engineering Oncolytic Virus to Target Cancer
Oncolytic viruses represent a promising approach to treating cancer for several reasons:
- Cancer cells often have impaired antiviral defenses that make them susceptible to infection.
- 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.
- 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.
Oncolytic Viruses target cancer cells
Oncolytic virus platforms used in clinical trials include:
T-VEC
- 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
How can cancer vaccines be classified?
As preventative, therapeutic, or personalized
Preventative cancer vaccines
- 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).
Therapeutic cancer vaccine
- 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
Personalized cancer vaccines
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.
Cancer vaccine targets relevant to the immune response to cancer
What can therapeutic cancer vaccines be based on?
Therapeutic cancer vaccines can be cell-based, protein based, or
nucleic acid based
There are two FDA approved therapeutic vaccines- Sipuleucel-T (Provenge®):
There are two FDA approved therapeutic vaccines- Bacillus Calmette-Guérin (BCG):
Bacillus Calmette-Guérin (BCG): a vaccine that uses weakened bacteria to stimulate the immune system; approved for patients with early-stage bladder cancer
What are neoantigens?
- 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
Combination of therapies to treat cancer
