Reasons for combining immunotherapy with chemo to enhance anti tumour response

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Published: 25 Mar 2014
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Prof Angus Dalgleish - St George's, University of London, London, UK

Dr Dalgleish talks to ecancertv at the 1st Immunotherapy of Cancer Conference ( ITOC ) in Munich about combining chemotherapy and immunotherapy.

Chemotherapy and Immunotherapy were always considered incompatible in the treatment of cancer. However, analysis of sequential use has revealed that there may be significant additive - if not synergistic - potential, in enhancing the immune response to cancer. 

There are many reasons why chemotherapy may enhance immune therapy. These include 1) the release of tumour antigens to a primed immune response, 2) the suppression and reduction of suppressor and regulatory T cells in the tumour and stromal tissues, 3) The priming of tumour cells to make them more visible to the immune response, 4) reduction of inflammatory and growth factor drive.

Enhancing the immune response prior to chemotherapy and releasing antigens as well as stimulating the immune response after chemotherapy or radiotherapy are both effective models. 

There is a good case to prime with non-specific vaccine activators, to then treat with chemotherapy followed by check point inhibitors and then low dose cytokines.