Department of Pathology, University of Virginia, Charlottesville, Virginia, USA.
Clin Transl Sci. 2021 Jan;14(1):120-131. doi: 10.1111/cts.12856. Epub 2020 Oct 29.
The capacity of the immune system to influence tumor progression has been a long-standing notion that first generated clinical traction over a 100 years ago when Dr. William Coley injected disaggregated bacterial components into sarcomas and noted that the ensuing inflammation commonly associated with tumor regression. Since then, our understanding of the individual components and the overall interaction of the immune system has expanded exponentially. This has led to the development of a robust understanding of how components of innate and adaptive immunity recognize and respond to tumors and leveraging this information for the development of tumor immunotherapies. However, clinical failures have also deepened our knowledge of how tumors might adapt/be selected to avoid or inhibit immune responses, which, in turn, has led to the further iteration of immunotherapies. In this tutorial, the established elements of tumor immunity are explained, and areas where our knowledge base is too thin is highlighted. The principles of tumor immunity that guide the development of cancer vaccines are further illustrated, and potential considerations of how to integrate cancer vaccines with conventional therapies and other immunotherapies are proposed.
免疫系统影响肿瘤进展的能力是一个由来已久的概念,早在 100 多年前就产生了临床吸引力,当时 William Coley 博士将分离的细菌成分注入肉瘤中,并指出随之而来的炎症通常与肿瘤消退有关。从那时起,我们对免疫系统的各个组成部分及其整体相互作用的理解呈指数级增长。这导致人们对先天和适应性免疫的各个组成部分如何识别和响应肿瘤有了深入的了解,并利用这些信息开发肿瘤免疫疗法。然而,临床失败也加深了我们对肿瘤如何适应/被选择以避免或抑制免疫反应的认识,这反过来又导致了免疫疗法的进一步迭代。在本教程中,解释了肿瘤免疫的既定要素,并强调了我们的知识库还很薄弱的领域。进一步说明了指导癌症疫苗开发的肿瘤免疫原则,并提出了如何将癌症疫苗与常规疗法和其他免疫疗法相结合的潜在考虑因素。