Solid tumor immunotherapy [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Solid tumor immunotherapy ======

With the advent of [[cancer immunotherapy]], there has been a major improvement in patients' [[quality of life]] and [[survival]]. The growth of cancer [[immunotherapy]] has dramatically changed our understanding of the basics of cancer biology and has altered the standards of [[care]] (surgery, radiotherapy, and chemotherapy) for patients. Cancer immunotherapy has generated significant excitement with the success of [[chimeric antigen receptor]] ([[CAR]]) [[T cell]] [[therapy]] in particular. Clinical results using CAR-T for hematological malignancies have led to the approval of four [[CD19]]-targeted and one [[B cell]] maturation antigen (BCMA)-targeted cell therapy products by the US Food and Drug Administration ([[FDA]]). Also, [[immune checkpoint inhibitor]]s such as antibodies against Programmed Cell Death-1 ([[PD-1]]), Programmed Cell Death Ligand-1 ([[PD-L1]]), and Cytotoxic T-Lymphocyte-Associated Antigen 4 ([[CTLA-4]]) have shown promising therapeutic outcomes and long-lasting clinical effect in several tumor types and patients who are refractory to other treatments. Despite these promising results, the success of cancer immunotherapy in [[solid tumor]]s have been limited due to several barriers, which include [[immunosuppressive tumor microenvironment]] (TME), inefficient trafficking, and heterogeneity of [[tumor antigen]]s. This is further compounded by the high intra-tumoral pressure of solid tumors, which presents an additional challenge to successfully delivering treatments to solid tumors
((Guha P, Heatherton KR, O'Connell KP, Alexander IS, Katz SC. Assessing the [[Future]] of [[Solid Tumor]] [[Immunotherapy]]. Biomedicines. 2022 Mar 11;10(3):655. doi: 10.3390/biomedicines10030655. PMID: 35327456; PMCID: PMC8945484.)).
----


Lu et al. showed that a bispecific nano[[bioconjugate]] that enables the decoration of [[SLAMF7]] on the surface of [[solid tumor]]s induces robust [[phagocytosis]] and activates the phagocyte [[cyclic guanosine monophosphate-adenosine monophosphate]] synthase-stimulator of [[interferon gene]]s [[cGAS-STING pathway]], sensitizing the tumors to [[immune checkpoint blockade]]. The findings support an immunological conversion strategy that uses [[nano adjuvant]]s to improve the effectiveness of [[immunotherapy]] for solid tumors
((Lu Y, Huntoon K, Lee D, Wang Y, Ha J, Qie Y, Li X, Schrank BR, Dong S, Gallup TD, Kang M, Zhao H, An Y, Yang Z, Li J, Kim BYS, Jiang W. Immunological conversion of solid tumours using a bispecific nanobioconjugate for cancer [[immunotherapy]]. Nat Nanotechnol. 2022 Nov 10. doi: 10.1038/s41565-022-01245-7. Epub ahead of print. PMID: 36357792.)).
----
[[Immunotherapy]] has had considerable success in treating several types of solid cancers, such as [[melanoma]] and [[lung adenocarcinoma]] 
((Drake CG, Lipson EJ, Brahmer JR. Breathing new life into immunotherapy: review of melanoma, lung and kidney cancer. Nat Rev Clin Oncol. 2014 Jan;11(1):24-37. doi: 10.1038/nrclinonc.2013.208. Epub 2013 Nov 19. PMID: 24247168; PMCID: PMC4086654.)).

===== Glioma immunotherapy =====

[[Glioma immunotherapy]].

===== Risks =====
Patients who receive [[immunotherapy]] (IT) alone may have an increased rate of [[Radiation induced necrosis]] RN/treatment-related imaging changes (TRIC) compared with those who receive [[chemotherapy]] (CT) or  targeted therapy (TT) alone after [[stereotactic radiosurgery]], whereas receiving any CT may in fact be protective against RN/TRIC. As the use of immunotherapies increases, the rate of RN/TRIC may be expected to increase compared with rates in the chemotherapy era
((Colaco RJ, Martin P, Kluger HM, Yu JB, Chiang VL. Does immunotherapy increase 
the rate of radiation necrosis after radiosurgical treatment of brain metastases?
J Neurosurg. 2015 Nov 6:1-7. [Epub ahead of print] PubMed PMID: 26544782.
)).

===== Metastases =====

[[Immunotherapy for metastases]].