Abstract
Peritoneal metastasis (PM) is an advanced stage malignancy largely refractory to modern therapy. Intraperitoneal (IP) immunotherapy offers a novel approach for the control of regional disease of the peritoneal cavity by breaking immune tolerance. These strategies include heightening T-cell response and vaccine induction of anti-cancer memory against tumor-associated antigens. Early investigations with chimeric antigen receptor T cells (CAR-T cells), vaccine-based therapies, dendritic cells (DCs) in combination with pro-inflammatory cytokines and natural killer cells (NKs), adoptive cell transfer, and immune checkpoint inhibitors represent significant advances in the treatment of PM. IP delivery of CAR-T cells has shown demonstrable suppression of tumors expressing carcinoembryonic antigen. This response was enhanced when IP injected CAR-T cells were combined with anti-PD-L1 or anti-Gr1. Similarly, CAR-T cells against folate receptor α expressing tumors improved T-cell tumor localization and survival when combined with CD137 co-stimulatory signaling. Moreover, IP immunotherapy with catumaxomab, a trifunctional antibody approved in Europe, targets epithelial cell adhesion molecule (EpCAM) and has shown considerable promise with control of malignant ascites. Herein, we discuss immunologic approaches under investigation for treatment of PM.
Highlights
Peritoneal surface malignancies and peritoneal metastasis (PM) develop from a broad spectrum of primary and metastatic malignancies [1,2]
Immunotherapy cancer vaccines have been an area of much interest for decades with significant advances being tailored towards IP treatment of peritoneal metastasis (Table 2 and Figure 3)
In a multicenter study to treatment and258 control groups determine effect of catumaxomab therapy onrandomized quality of life by Wimberger et al, patients withtoovarian andthe non-gynecologic malignancies were to Results were determined by patient questionnaires
Summary
Peritoneal surface malignancies and peritoneal metastasis (PM) develop from a broad spectrum of primary and metastatic malignancies [1,2]. Improving patient outcomes, leads to survival rates ranging between. The potential benefit of combined cytoreduction and HIPEC was shown by Verwaal and colleagues in patients with benefit of combined cytoreduction and HIPEC was shown by Verwaal and colleagues in patients colorectal peritoneal metastasis. They cited nearly doubling of 2 year survival rates beyond standard with colorectal peritoneal metastasis. White and pelvis depicting extensive peritoneal metastasis and tumor burden from appendiceal cancer.
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