Pharmacologic Modulation of Human Immunity in the Era of Immuno-oncology: Something Old, Something New

• Published in: Mayo Clinic proceedings Vol. 93; no. 7; pp. 917 - 936
• Main Authors: Bangalore Kumar, Anagha, Maus, Rachel, Markovic, Svetomir N.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.07.2018; Frontline Medical Communications Inc; Elsevier Limited
• Subjects: Analysis; Antigens; Antineoplastic Agents, Immunological - therapeutic use; Apoptosis; Biomarkers; Cancer immunotherapy; Cell proliferation; Cytotoxicity; Dosage and administration; Drug therapy; Epidermal growth factor; Epigenetics; Humans; Immune checkpoint; Immune system; Immunoglobulins; Immunotherapy; Ipilimumab; Kinases; Lung cancer; Lymphocytes T; Lymphoma; Melanoma; Metastasis; Monoclonal antibodies; Mutation; Nanoparticles; Neoplasms - therapy; Oncology; PD-L1 protein; Polyethylene glycol; Proteins; Risk factors; Survival analysis; T cell receptors; Targeted cancer therapy; Tumor necrosis factor-TNF; Tumors; Vaccines; Viruses; ALK; CLL; FDA; RANKL; CDC; FL; TNF; EGFR; T-VEC; IFN; NHL; GM-CSF; CMC; PD-L1; CTLA-4; LFT; PFS; ADCC; RFS; IL; OR; NSCLC; OS; VEGF; IV; ACT; MMR; PEG; RCC; CAR; HNSCC; TIL; HER2; PD-1; DC
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2018.03.028

The concept of exploiting the immune system to treat cancer forms the basis of immuno-oncology. Since its birth in the late 1800s, immuno-oncology, or cancer immunotherapy, has come a long way. With better understanding of the complex relationship between tumor and the immune system, we have been able to explore and develop various modalities of anticancer therapies. In this review, we summarize the main strategies of immunotherapy that are available today: monoclonal antibodies, anticancer vaccines, cytokines, and adoptive T-cell therapy. We also highlight the unique set of adverse effects associated with modern immunotherapy and propose nonsteroidal immunomodulators and anticytokine antibodies as treatment options for toxicities. The future of immuno-oncology is discussed, including combination therapy, drug-antibody conjugates, epigenetic drugs, using nanoparticles for drug delivery, new antigen discovery, and developing biomarkers to assess treatment responses. A data search was conducted using PubMed and included studies published through November 1, 2017. Search terms used include cancer immunotherapy, pembrolizumab, ipilimumab, nivolumab, PD-1 inhibitors, PD-L1 inhibitors, checkpoint inhibitors, anticancer vaccines, TVEC, and adoptive cell therapy.