93INANTI-CANCER T CELLS CAN TARGET THE TWO PILLARS OF MALIGNANCY, I.E. CANCER CELL-INTERNAL AND -EXTERNAL DISEASE MECHANISMS

• Published in: Annals of oncology Vol. 25; no. suppl_4; p. iv35
• Main Author: Speiser, D.
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.09.2014
• DOI: 10.1093/annonc/mdu311.1
• ISSN: 0923-7534

Abstract During the last few years, immunotherapy has brought significant progress in clinical oncology. Major breakthroughs were made in melanoma patients, but also in patients with very frequent diseases such as lung and kidney cancer. This has sparked broad enthusiasm for the further development of immunotherapy, which is now becoming a major treatment option. Unfortunately, however, still many patients experience progressive disease. Potential reasons for cancer “resistance” and “evasion” are based on the two pillars of malignancy, i.e. cancer cell-internal (i) and -external (e) disease mechanisms. First, cancer cells may directly resist to (therapeutic) molecules and cells with anti-cancer potential (i). And second, cancer cells can exploit the human body systems to support persistence and progression of primary tumors and metastases, and entertain “wounds that never heal” (e). The recent immunotherapy success in clinical oncology builds on the profound experience acquired since many years in hemato-oncology: After allogeneic hematopoietic stem cell transplantation, the graft-versus-leukemia (GvL) effect can assure long-term remission of patients with hematological malignancies. T cells play a central role in GvL. Similarly, T cells are central players in immunity to solid tumors. They can act against both malignancy pillars. First, they can directly destroy cancer cells, and second, they can revert a tumor-friendly (micro-) environment into a tumor-hostile one, by changing the patient's biology towards “healing wounds”. Therapeutic success depends on broad and long-term targeting. T cells are superior in achieving this goal than pharmaceutical drugs alone. Simultaneous therapeutic pressure against both malignancy pillars provides a solid basis to minimize “escape” and for further development of novel therapies against cancer. Disclosure: The author has declared no conflicts of interest.