How the Immune System Normally Fights Cancer
The immune system plays a vital role in protecting the body from diseases. When cancer develops, the immune system is usually able to recognize cancer cells as foreign and eliminate them before they can grow into detectable tumors. Specialized white blood cells called T cells scan the body for anything abnormal or damaged. When a T cell encounters a cancer cell, it initiates an immune response to destroy the cancerous threat.
How Cancer Evades the Immune System
However, Cancer Immunotherapy have evolved ways to avoid detection and evade elimination by the immune system. Some tumors secrete proteins that confuse or suppress nearby T cells, preventing an immune response from developing. Cancer cells may also express surface proteins that mimic those of normal cells, fooling T cells into ignoring them. In other cases, the tumors themselves release substances that actively inhibit T cell function. As a result, the cancer is able to grow unchecked into a detectable tumor mass. Effectively "tying the hands" of the immune system allows cancers to establish themselves and progress.
Reawakening the Immune System with Immunotherapy
Cancer immunotherapy is an innovative treatment approach that aims to help the immune system overcome tumor evasion mechanisms and mount an effective anti-cancer response. Different immunotherapy strategies are being developed and tested both alone and in combination with other therapies like chemotherapy or radiation. Some key immunotherapy methods include:
Checkpoint inhibitors - These drugs block specific inhibitory proteins expressed by cancers that shut down immune responses. By inhibiting checkpoints like PD-1 or CTLA-4, T cells are freed to recognize and attack tumor cells.
Adoptive cell transfer - Immune cells (T cells or Natural Killer cells) are removed from a patient and genetically engineered to better detect cancer. They are then returned in large numbers to seek out and destroy tumors throughout the body.
Vaccines - Similar to traditional vaccines that prime immunity against infection, cancer vaccines try to induce an immune response against specific molecular targets found on tumors. This trains the immune system to identify and eliminate cancerous cells presenting those same targets.
Cytokines - These are proteins normally involved in immune signaling. Giving cytokines like interferons as drugs aims to boost or redirect existing anti-tumor immunity mediated by T cells and other immune cells.
Oncolytic viruses - Genetically modified viruses are designed to selectively infect and kill cancer cells while leaving healthy tissue unharmed. As cancer cells die, they release new tumor antigens to stimulate the immune system.
Improving Cancer Immunotherapy Outcomes for Many Cancer Types
The immune system has great potential to destroy cancers, and immunotherapy is starting to realize this potential. Checkpoint inhibitors in particular have shown stunning success in treating some metastatic and hard-to-treat cancers including melanoma, lung cancer, bladder cancer, and Hodgkin's lymphoma. Complete and long-lasting remissions are possible. Immunotherapy is also being combined with other therapies to enhance results across a growing list of cancer types. While immunotherapy does not work for every patient or cancer, outcomes are steadily improving as our understanding of tumor immunology grows. The future holds promise for more personalized and effective immunotherapies able to transform cancer into a manageable condition for many more people.
Ongoing Challenges and Future Directions
Despite real progress, challenges remain. Some tumors still seem reluctant to provoke an immune response. Identifying methods to make "cold" tumors more visible to T cells is actively being researched. Combination strategies blending immunotherapy with targeted drugs, radiation, surgery or other approaches hold promise but require optimized treatment sequencing and schedules. Managing immunotherapy side effects like fatigue, rashes or inflammation also requires attention. Moving forward, new diagnostic tests are needed to better predict who will benefit from specific immunotherapies. Large clinical trials continue exploring optimal combinations, dosing, and sequencing over months or years of therapy. With additional research gains, cancer immunotherapy offers hope to transform patient outcomes and change the landscape of cancer treatment for the better.
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