Active Immunotherapy in cancer – Current Status

Abstract

Immunotherapy is a fourth pillar in cancer management after surgery, radiotherapy and chemotherapy. Active immunotherapy works by inducing antigen specific immune response following its administration while checkpoint inhibitor works by reducing tumor induced immunosuppression and thereby utilizing pre-existing immune response. Adoptive cell therapy (ACT) is a type of personalized therapy wherein cells are harvested from a patient, expanded and reintroduced. The T cells are genetically modified in chimeric antigen receptor T cell (CAR-T) therapy while tumor infiltrating cells are used in in ACT and dendritic cells are used in dendritic cell (DC) vaccine. Vaccine induces T cell response against the antigen of interest. T cells available following single administration are higher in ACT compared to vaccine approach. CAR-T cells are found useful in refractory large B-cell lymphoma and refractory large B-cell precursor acute lymphoblastic leukemia. ACT is found useful in melanoma. Vaccines are approved for melanoma as a monotherapy and for non-small cell lung cancer in combination with chemotherapy.