cancer - immunology and cancer treatments

immunosurvelliance

Immune system recognizes and destroys pathogens like
bacteria, viruses and fungi by utilizing several mechanisms
• It is reasonable to believe the the immune system
continuously monitors its tissues for the presence of cancer
cells; after recognition it would treat these cancer cells just
like foreign pathogens and destroy them before they gain
the ability to proliferate and form tumors

immunosurveillance

Immunosurveillance and Immunotherapies
• T-cell activation
• Checkpoint inhibitors
• CAR-T cell therapy
• Molecular and targeted therapies
• kinase inhibitors
• First generation therapies

TIL therapy –

tumor infiltrating
lymphocytes from the patients
tumor are extracted and then
amplified; large numbers are
then infused back into the
patient
•

car T cell therapy

CAR T-cell therapy – similar to TIL therapy, except the T cells are genetically engineered to
express CAR

Used for treatment in lymphomas and leukemias

immune check point inhibitors

immune Checkpoint Inhibitors -
block proteins called checkpoints that are expressed on the surface of immune cells
and some cancer cells (see figure)
• Checkpoints keep the immune response from being too strong and can prevent T cells from killing cancer cells
• Example of a checkpoint is PD-1/PD-L1; Nivolumab (Opdivo)
• Used to treat many types of cancers including melanoma, lung, kidney, bladder, breast and lymphomas

heraciptin

Tyrosine kinase inhibitors
• Herceptin = Trastuzumab
• Used for the treatment of breast cancers that are HER2 positive
• Overexpression of HER2 is detected
• Blocks the HER2 receptor and prevents the downstream effects shown in the
figure

imatinib

Imantinib (Gleevek) is used for the treatment
of CML (chronic myelogenous leukemia)
• BCR-ABL fusion gene is formed in CML due to a chromosomal translocation and the
formation of the Philadelphia chromosome
• BCR-ABL is an overactive tyrosine kinase; Imantinib blocks its activity

First Generation Therapies

Cisplatin - platinum binds to DNA and damages it, inducing death of cancer cells – Testicular Cancer

Vincristine sulfate – Acute Leukemia, Neuroblastoma, Hodgkin Lymphoma

Tamoxifen and Raloxifene – Breast Cancer

Finasteride or dutasteride - 5 alpha reductase inhibitor – Prostate Cancer