Abstract
Cancer-related deaths are approaching 10 million each year. Survival statistics for some cancers, such as ovarian cancer, have remained unchanged for decades, with women diagnosed at stage III or IV having over 80% chance of a lethal cancer recurrence after standard first-line treatment (reductive surgery and chemotherapy). New treatments and adjunct therapies are needed. In ovarian cancer, as in other cancers, the immune response, particularly cytotoxic (CD8+) T cells are correlated with a decreased risk of recurrence. As well as completely new antigen targets resulting from DNA mutations (neo-antigens), these T cells recognize cancer-associated overexpressed, re-expressed or modified self-proteins. However, there is concern that activation of self-reactive responses may also promote off-target pathology. This review considers the complex interplay between cancer-reactive and self-reactive immune cells and discusses the potential uses for various leading immunomodulatory compounds, derived from plant-based sources, as a cancer therapy option or to modulate potential autoimmune pathology. Along with reviewing well-studied compounds such as curcumin (from turmeric), epigallocatechin gallate (EGCG, from green tea) and resveratrol (from grapes and certain berries), it is proposed that compounds from novel sources, for example, native Australian plants, will provide a useful source for the fine modulation of cancer immunity in patients.
Highlights
The impact of cancer is seen globally, and it is one of the biggest burdens of disease, both in terms of morbidity and quality of life
Many immune cell subsets are present in the tumour microenvironment (TME), creating complex interactions involved in the pro-tumour or anti-tumour response
Encouraging patient outcomes have already been observed in melanoma [4], non-small-cell lung carcinoma [5] and urothelial cancer [6] when modulating the immune response with T cell checkpoint inhibitors
Summary
The impact of cancer is seen globally, and it is one of the biggest burdens of disease, both in terms of morbidity and quality of life. Encouraging patient outcomes have already been observed in melanoma [4], non-small-cell lung carcinoma [5] and urothelial cancer [6] when modulating the immune response with T cell checkpoint inhibitors. Not limited to particular cancer types, irAEs have been observed in patients with non-small-cell lung carcinoma [13,14], melanoma [15,16], ovarian cancer [17,18] as well as others In each case, these typically present as dermatological, gastrointestinal and/or endocrine inflammatory side effects, e.g., dermatitis, colitis, and pancreatitis (reviewed by Trinh et al [9]) [19]. We will describe the immune system and potential utilities of self-reactive cells and outline the evidence for natural compounds as novel adjunct therapeutic options as well as potential alternatives to treating off-target effects
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