Summary of Presentations from the 11th Targeted Therapies for Lung Cancer Meeting; Immunotherapy and Vaccines for Treatment of Lung Cancer

Abstract

Immune-based interventions are steadily broadening the range of choices among cancer prevention and treatment modalities. Recent major advances in the therapy of lymphoid malignancies and prevention of cervical cancer (to name a few) fuel the interest of investigators and clinicians who tried for decades to exploit the potential of the immune system to control the disease. Lung cancer presents a more challenging group of diseases, where major breakthroughs in immunotherapy or vaccination are yet to be seen. The following update may elicit cautious optimism for some areas of this endeavor. Dr. Scott Antonia summarized the essential processes by which the immune system recognizes and responses to tumor-associated antigens (TAAs) on tumor cells. From the MHC Class I antigen processing pathway, dendritic cellbased activation to cytotoxic T lymphocytes (CTLs) to the list of various types of tumor-associated antigens and evidence of the presence of specific CTLs for individual TAAs; experimental and clinical data provide the rationale for the development of tumor vaccines (Table 1). Nevertheless, once vaccines are tested in clinics, there is a “glass ceiling” with a tumor response rate of 5 to 10%. Efficacy can only be improved by developing combination immunotherapy with the use of (1) immunomodulatory agents (T-cell growth factors, anticheckpoint, or costimulatory agents); (2) elimination of suppressive cells; (3) inactivation of suppressive cytokines and factors in the tumor microenvironment; and (4) sequencing with chemotherapy.