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Combination cancer immunotherapies tailored to the tumour microenvironment
Abstract
Evidence suggests that cancer immunotherapy will be a major part of the combination treatment plan for many patients with many cancer types in the near future. There are many types of immune processes involving different antitumour and tumour-promoting leucocytes, and tumour cells use many strategies to evade the immune response. The tumour microenvironment can help determine which immune suppressive pathways become activated to restrain antitumour immunity. This includes immune checkpoint receptors on effector T-cells and myeloid cells, and release of inhibitory cytokines and metabolites. Therapeutic approaches that target these pathways, particularly immune-checkpoint receptors, can induce durable antitumour responses in patients with advanced-stage cancers, including melanoma. Nevertheless, many patients do not have a good response to monotherapy approaches and alternative strategies are required to achieve optimal therapeutic benefit. These strategies include eliminating the bulk of tumour cells to provoke tumour-antigen release and antigen-presenting cell (APC) function, using adjuvants to enhance APC function, and using agents that enhance effector-cell activity. In this Review, we discuss the stratification of the tumour microenvironment according to tumour-infiltrating lymphocytes and PD-L1 expression in the tumour, and how this stratification enables the design of optimal combination cancer therapies tailored to target different tumour microenvironments.
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“On the other hand, some positive factors such as immunogenic cancer cell death, immunosupportive cytokines, and professional antigen presentation cells (pAPCs) contribute to immune clearance [21].”
From Combination strategies with PD-1/PD-L1 blockade: current advances and future directions (2022) · cites this paper as [21]
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“Despite the exciting and encouraging clinical responses obtained, the majority of patients treated with anti-CTLA-4, anti-PD-1, or anti-PD-L1 monotherapy still show none or partial objective responses.(1) Therefore, to achieve durable tumor regression in melanoma and CRC patients, there is a strong need to design new…”
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“Primary resistance to Immune checkpoint inhibitors (ICIs) has been linked to different factors, including poor intrinsic antigenicity of malignant cells, lack of priming by potentially immunogenic pretreatment with radio-, or/and chemotherapy (17), poor antigen presentation at the time of the priming phase (18), immun…”
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“Additionally, while there have been advancements in immunotherapy techniques in recent years to boost the body’s immune response against tumors, treatment efficacy remains limited due to the tumor’s immune suppressive environment and the considerable differences between individuals [7–12].”
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“Accordingly, personalised combination strategies that are tailored to individual patients’ specific TMEs hold immense promise for the next generation of cancer immunotherapies (115).”
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“The introduction of checkpoint (programmed death 1/programmed death ligand 1, PD1/PDL1) or cytotoxic T lymphocyte-associated 4 (CTLA-4) inhibitors has substantially increased patients’ life expectancy (Ott et al., 2013; Smyth et al., 2016).”
BackgroundAlhamhoom, Y., Kakinani, G., Rahamathulla, M., Osmani, R. A. M., Hani, U., Thajudeen, K. Y., Raj, G. K., & Gowda, D. V. (2022) · Saudi Pharmaceutical Journal · doi:10.1016/j.jsps.2022.12.008 · Cited by 26
“Antibodies against programmed cell death protein 1 (PD1), IL-10, and cytotoxic T -lymphocyte–associated antigen 4 (CTLA-4) have contributed to the development of immunotherapy techniques (Smyth et al., 2015, Stewart and Keselowsky, 2017).”
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“Most solid tumors include a variety of immune cells, such as regulatory T cells and TAMs, which can inhibit CTLs function (22, 23).”
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“The efficacy of cancer immunotherapy may be enhanced by a combination of different immunotherapeutic approaches that include activation of both adaptive and innate immunity and inhibition of immunosuppressive mechanisms (6,7).”
BackgroundMultifunctional Nanomodulators Regulate Multiple Pathways To Enhance Antitumor Immunity
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“Currently, nanoparticle-based cancer immunotherapy, a strategy by activating the immune system and enhancing its adaptive power for cancer treatment via nanoparticles, has been considered as one of the most promising treatments for cancer therapy [2, 3].”
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“Further, the enhancement of anti-PD1 efficacy by MP0250 (Figure 6) indicates the potential for combination therapy with the immunetherapeutic molecules that are currently revolutionizing cancer therapy [38].”
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Metadata
- Authors
- Smyth, M. J., Ngiow, S. F., Ribas, A., & Teng, M. W. L.
- Affiliations
- QIMR Berghofer Medical Research Institute (AU)
- University of California, Los Angeles (US)
- Corresponding author
- Teng, Michele W. L.
- Venue
- Nature Reviews Clinical Oncology
- Published
- 2015-11-24
- Volume
- 13
- Issue
- 3
- Pages
- 143-158
- ISSN
- 1759-4774 (ISSN-L)
- 1759-4782
- OpenAlex
- W2257916459
- Cited by
- 944
- References
- 218
- Citations by year
- 2026: 28 · 2025: 50 · 2024: 71 · 2023: 82 · 2022: 132 · 2021: 102 · 2020: 134 · 2019: 95 · 2018: 99 · 2017: 89 · 2016: 56 · 2015: 3
- FWCI
- 8.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Amgen
- Bristol-Myers Squibb
- Kite Pharma
- National Cancer Institute (R35CA197633)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Keywords
- cancer immunotherapy, combination therapy, tumor microenvironment, immune evasion, immune checkpoint receptors, PD-L1, tumor-infiltrating lymphocytes, myeloid cells, inhibitory cytokines, antigen-presenting cells, adjuvants, melanoma
- MeSH terms
- Adjuvants, Immunologic, Animals, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Humans, Immunotherapy, Neoplasms, Signal Transduction, Treatment Outcome, Tumor Escape, Molecular Targeted Therapy, Tumor Microenvironment, B7-H1 Antigen
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