JUNE is Cancer Immunotherapy month

Perhaps a little known fact is that JUNE is Cancer Immunotherapy month.

As the Topic of Cancer Laboratory at Surrey University starts to re-open after Covid19 Lockdown and resume research, it is timely for Topic of Cancer to raise awareness about these ground breaking therapies that challenge conventional cancer treatments

Some facts about immunotherapy and our immune system

  • The immune system is highly evolved to fight infections and cancer
  • Cancers are not solid lumps of tissue, but complex ecosystems
  • Immunotherapy has become standard of care for many cancers, some even ahead of chemotherapy
  • Immunotherapies take many forms- they are ‘indirect’ treatments by kick starting the immune system to recognise and fight the cancer
  • Cancers are colonised by bacteria – some help the cancer survive: removing these will form part of the net wave of immunotherapies

The Immune System

The increase in human life expectancy over millenia has been mainly as a result of our immune system’s ability to fight microbial infection: we rely on its rapidity, precision, adaptation and efficiency. All of these features are ideal for the immune system to target cancer in a similarly lethal way. The evolution of knowledge in how the immune system works encompasses amongst the greatest scientific minds and has been littered with Nobel prize awards along the way. From early success such as antibody therapy and immune molecules such as interferon and interleukin-2, we have made gigantic leaps forward over 15 years such that we are now considering immunotherapy as the first option for a number of cancers- ahead of conventional cancer treatments. While individual drugs may have made the headlines, this success is due to sustained investment in the science and our understanding how the immune system works in health, and how this is subverted in countless ways in cancer.

T Cell lymphocyte with receptors for cancer cell immunotherapy research.

Fighting the cancer cells through adaptation of ecosystems

In all cancers, even tiny early cancers, the immune system detects the cancer and sends in immune cells to try and combat. In time, as the cancer grows, this immune response is subdued and, ultimately, suppressed completely. Cancers then form complex ecosystems, comprising cancer cells, normal structural cells, blood vessels, ‘good’ and ‘bad’ immune cells in a conformation that has texture or ‘sponginess’, regions of differing oxygenation and variable tissue density. This ecosystem favours and sustains the cancer.

New immunotherapies are therefore trying to target cancers cells and components of this ecosystem. We now also know that most cancers are colonised with bacteria, and the type of bacteria inside cancer cells may help damage the cancer or allow it to flourish. Altering the resident bacteria in cancers will form part of future treatments.

Stimulating the immune system –

improving survival rates for aggressive cancers

Immunotherapy treatments of cancer are not direct assaults on tumours but more indirect, by stimulating production of immune cells (T cells, B cells, natural killer cells), which then traffic to the tumour, and try and cause damage of the cancer cells specifically. However, this has proved insufficient as a treatment: the great progress has been how to enhance these immune cells further by removing the ‘brakes’ the body normally applies (to stop immune cells becoming overactive). As a result, and 2 more Nobel prizes later, we have 2 immunotherapies, ipilimumab and nivolumab, which allows over half the patients with aggressive melanoma to survive 10 years, versus the dismal 6-9 months we expected previously.

These drugs were the spark- we are now in times of incredible technical analytical sophistication and generation of supercharged immune cells as the next generation of treatments. What is changing quickly further is the need for a broader or ‘systems’ approach- we know we have to change the physical structure of the ecosystem (or ‘tumour microenvironment’) the cancers have evolved to protect itself (i.e. damage it with drugs, cancer killing viruses or radiation) and combine this with immune attack.

A new generation of antibodies –

especially to treat lung and prostate cancer

These are exciting times: engineered T cells, dendritic cell, cancer vaccines, the next generation of antibodies (called bi-specifics) are a few examples of what’s is heading rapidly to the clinic, and for cancers where immune manipulation was thought never to be possible such as lung cancer and prostate cancer.

It would be great if you could engage with Cancer Immunotherapy Month. You can donate to Topic of Cancer using our page on Virgin moneygiving page, or perhaps, you could raise money for our research team. Every little helps, and is greatly appreciated.

You can read more about immunotherapy on our website by clicking here.

The complex tumour microenvironment
T Cell lymphocyte with receptors for cancer cell immunotherapy research.
Image courtesy of:
Iratxe Zuazo-Gaztelu et al. Unravelling the Role of Angiogenesis in Cancer Ecosystems Front. Oncol., 02 July 2018

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