Financial Support Needed for Cancer Immunotherapy

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Where Next for Cancer Immunotherapy?

The promise will only be realized with more support

By Ira Mellman DESPITE ITS OBVIOUS SCIENTIFIC APPEAL, immunotherapy

as an approach to cancer has yet to live up to expectations. Initial

attempts at using cytokines to stimulate anticancer T cells, or

deploying toxin-conjugated monoclonal antibodies as " magic bullets, "

were never quite successful despite having attracted considerable

attention.

THE IMPORTANCE OF MATURITY:

In the path from peripheral tissue to lymph node, dendritic cells

mature to the point at which they can arm B cells, T cells, natural

killer cells, and NKT cells to attack tumors.

Click to view largerTherapeutic vaccines for cancer have proven

similarly disappointing. Rosenberg, a noted cancer

immunologist at the National Cancer Institute, reviewed progress to

date in 2004 and concluded that the objective clinical response rate

for roughly 1,000 patients fell below an unimpressive 4%.1 Skepticism

and a lack of support has impeded research in the area such that even

a role for the immune system as a natural surveillance mechanism to

detect and eliminate incipient cancers remains without wide

acceptance, despite a large body of experimental and clinical

evidence.2

Yet, as a treatment for diseases other than cancer, immunotherapy ñ

defined broadly as modulation of the immune system for therapeutic

benefit ñ has emerged as one of the most exciting, promising, and

effective treatment strategies for chronic inflammatory disorders,

diabetes, transplantation, and other debilitating conditions (see

the " Success Stories " sidebar below). Is it really not a viable

approach in cancer?

The fact is that most work to date has been conducted in the absence

of sufficient knowledge of the human immune response, particularly

the response to cancer. Thus it is dangerously premature to conclude

that cancer vaccines will not work when they have yet to be

adequately conceived, supported, and coordinated.

THE STATE OF CANCER THERAPY

Despite dramatic advances in our understanding of cancer cell biology

and continuous if incremental gains in cancer treatment efficacy,

conventional therapy has remained fundamentally unchanged for

decades. In general, treatment still involves surgery, where

possible, followed by broad-spectrum cytotoxic chemotherapy in an

attempt to kill the patient's cancer before killing the patient.

Even with dramatic advances in our understanding, cancer therapy

still generally involves broad-spectrum cytotoxic chemotherapy in an

attempt to kill the patient's cancer before killing the patient. Two

recent developments have begun to change this situation. First,

targeted chemotherapeutic drugs such as Gleevec, Sutent, Tarceva, and

Iressa zero in on specific tyrosine kinases, or kinase mutants,

associated with a given cancer cell's survival or proliferation.

Although promising, such agents have thus far proved most effective

in treating relatively rare cancers.

Second, there has been a veritable renaissance in monoclonal

antibodies (mAbs). These can be considered immunotherapeutics, as

their very production requires mobilizing a core feature of the

immune system, and in many cases they initiate elements of the

patient's immune system (e.g., natural killer cells and macrophages),

either to kill antibody-coated tumor cells or possibly help stimulate

anticancer immunity.

Read the rest at:

http://www.the-scientist.com/article/display/18859/