Immunotherapy and Immunoprofylaxis for Cancer Patients: Paradigm Shift

Abstract

A concept of paradigm shift identified by Thomas Kuhn in 1962 implies a fundamental change in the basic concepts and experimental practices of a scientific discipline. A scientific revolution occurs, according to Kuhn, when scientists encounter anomalies that cannot be explained by the universally accepted paradigm within which scientific progress was made. In the beginning of the 21st century the oncologists faced with the crisis of chemotherapeutic approach to treating several neoplasms, especially in adults. The appearance of new chemotherapeutic drugs was not able to solve problem. At the same time new non-chemotherapeutic agents such anti CD20, anti GD2, protein kinase inhibitors proved their usefulness in some types of cancer. In the patients who underwent allogeneic stem cell transplants, the «graft-versus-tumor» effect was revealed to be beneficial for the recipient by eliminating residual malignant cells and to be used as a base for further immunotherapeutic modalities. There are two groups of cancer patients divided by effectiveness of chemotherapy and impact of used chemotherapeutic programs on patients’ survival. Obviously, the patients must go on to benefit from chemotherapeutic protocols, if the 5- and more years disease-free survival reaches >65–80%. But in the patients with long-term survival <5–20% with no plate on disease-free survival curve, it seems to be reasonable to hold on the conventional chemotherapy and maybe radiotherapy, and to put at the forefront a new immunotherapeutic concept for treating such types of neoplasms. In the article we propose to think over the chemotherapeutic paradigm shift and consider some immunological options for patients with cancer who failed conventional treatment.