Clinically feasible and prospective immunotherapeutic interventions in multidirectional comprehensive treatment of cancer

ABSTRACT

Introduction

The immune system is able to exert both tumor-destructive and tumor-protective functions. Immunotherapeutic technologies aim to enhance immune-based anti-tumor activity and (or) weaken tumor-protective immunity.

Areas covered

Cancer vaccination, antibody (Ab)-mediated cytotoxicity, Ab-based checkpoint molecule inhibition, Ab-based immunostimulation, cytokine therapy, oncoviral therapy, drug-mediated immunostimulation, exovesicular therapy, anti-inflammatory therapy, neurohormonal immunorehabilitation, metabolic therapy, as well as adoptive cell immunotherapy, could be coherently used to synergize and amplify each other in achieving robust anti-cancer responses in cancer patients. Tumor-specific immunotherapy applied at early stages is capable of eliminating remaining tumor cells after surgery, thus preventing the development of minimal residual disease. Patients with advanced disease stages could benefit from combined immunotherapy, which would be aimed at providing tumor cell/mass dormancy. Traditional therapeutic anti-cancer interventions (chemoradiotherapy, hyperthermia, anti-hormonal therapy) could significantly enhance tumor sensitivity to anti-cancer immunotherapy. It is important that lower-dose (metronomic) chemotherapy regimens, which are well-tolerated by normal cells, could advance immune-mediated control over tumor growth.

Expert opinion

We envisage that combined immunotherapy regimens in the context of traditional treatment could become the mainstream modality for treating cancers in all phases of the tumorigenesis. The effectiveness of the anti-cancer treatment could be monitored by the following blood parameters: C-reactive protein, lactate dehydrogenase, and neutrophil-to-lymphocyte ratio.

KEYWORDS:

• Combined antitumor immunotherapy
• cancer vaccination
• antibody-based therapy
• adoptive cell immunotherapy
• drug-based immunostimulation
• cancer prognosis

Article highlights

• Combined immunotherapy regimens aim to enhance anti-tumor immunity and (or) weaken tumor-protective immunity.

• Various immunotherapeutic interventions can amplify each other in achieving anti-cancer effects.

• Immunotherapy applied at early disease stages is capable of eliminating remaining tumor cells after surgery.

• Immunotherapy applied at advanced stages can result in long-term tumor cell/mass dormancy.

• Traditional anti-cancer therapies can enhance tumor sensitivity to immunotherapy.

• Inflammatory blood markers can serve as prognostic factors for cancer outcome.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper is not funded.