Recent Breakthrough in Cancer in Immunotherapy
Author Name: Rebecca J
Category Name: Medical Science
Prostate cancer and brain cancer, especially an aggressive form known as glioblastoma, are two other types of tumors that have proven resistant to checkpoint immunotherapy, at least when it’s used alone. However, as Dr. Sharma noted, encouraging signs of progress have been seen. In prostate cancer, the CRI- and PICI-funded PORTER trial is exploring a number of novel immunotherapy combinations to tackle this disease. The adaptive design of this trial, which allows for other promising combinations to be added in the future, may also serve as a model for future clinical trials seeking to address other cancer types. In glioblastoma, Dr. Sharma pointed to recent evidence that appears to suggest that immune cells called myeloid cells may play an important role in patient responses. In the coming year, she expects that we will start to see treatments targeting these myeloid cells in combination with existing checkpoint immunotherapies that target the PD-1 and CTLA-4 pathways involved in T cell inhibition.
Next, Dr. Sharma focused on two other immunotherapy approaches: CAR T cells and cancer vaccines. CAR T cells have already been effective in blood cancers, especially leukemia and lymphoma, but Sharma stressed that versions with additional genetic modifications—such as those in which the PD-1 “brake” has been deleted—are being tested in order to extend their benefits to solid cancers. CAR T cell therapies might also benefit from being combined with existing checkpoint immunotherapies. When it comes to vaccines, in particular those that target patient-specific mutations known as neo-antigens, they’ve proven capable of initiating immune responses against patients’ cancers. However, to achieve meaningful clinical benefit, they will likely need to be combined with other treatments in order to enable vaccine-associated immune responses to be maintained and eliminate tumors. Fortunately, these personalized vaccines have become less costly and easier to manufacture in recent years, which should enable them to be incorporated into treatment strategies more easily in the coming years.
While much of the “low-hanging fruit” of immunotherapy has already been plucked for the benefit of patients, the solutions to the field’s remaining challenges will require even more intense investigation and collaboration. As Sharma said, “It's been clear that the more people you put in the room that are focusing on a problem, the better the chances are that you can come up with strategies that work… we each have our strengths that we bring to the table. And not one person is going to solve all the problems. So that's why it's important to have teams that work together.”
CRI’s Clinical Accelerator—which has been involved in the aforementioned PRINCE and PORTER clinical trials—serves as a great example of how to bring multiple stakeholders together in order to pursue a common goal against cancer.
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Journal of Cancer Clinical Trials
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