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The Community Oncologist

Cancer and Immune Response: Old and New Evidence for Future Challenges

^aMedical Oncology Department, Virgen de la Macarena University Hospital, Seville, Spain; ^bPfizer Medical Department, Madrid, Spain

Key Words. Cancer • Tumor-infiltrating lymphocytes • Immune tolerance • Cancer vaccines • CTLA-4 • GM-CSF • IL-2

Correspondence: Luis de la Cruz-Merino, M.D., Servicio de Oncología Médica, Hospital Universitario Virgen de la Macarena, Avenida Doctor Fedriani, 3, 41071 Sevilla, Spain. Telephone: 0034-955008934/955008932; Fax: 0034-954902219; e-mail: lucme12{at}yahoo.es

Received August 1, 2008; accepted for publication October 28, 2008; first published online in THE ONCOLOGIST Express on December 4, 2008.

Disclosure: Employment/leadership position: Enrique Grande-Pulido, Pfizer Pharmaceuticals; Intellectual property rights/inventor/patent holder: None; Consultant/advisory role: None; Honoraria: None; Research funding/contracted research: None; Ownership interest: Enrique Grande-Pulido, Pfizer Pharmaceuticals; Expert testimony: None; Other: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or staff managers.

Cancer may occur as a result of abnormal host immune system tolerance. Recent studies have confirmed the occurrence of spontaneous and induced antitumor immune responses expressed as the presence of tumor-infiltrating T cells in the tumor microenvironment in some cancer models. This finding has been recognized as a good prognostic factor in several types of tumors. Some chemotherapy agents, such as anthracyclines and gemcitabine, are effective boosters of the immune response through tumor-specific antigen overexpression after apoptotic tumor cell destruction. Other strategies, such as GM-CSF or interleukin-2, are pursued to increase immune cell availability in the tumor vicinity, and thus improve both antigen presentation and T-cell activation and proliferation. In addition, cytotoxic T lymphocyte antigen 4–blocking monoclonal antibodies enhance immune activity by prolonging T-cell activation. Strategies to stimulate the dormant immune system against tumors are varied and warrant further investigation of their applications to cancer therapy in the future.

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