Part of the book: Drug Discovery and Development
Colorectal cancer (CRC) remains one of the most common malignancies and the second leading cause of cancer‐related death worldwide; treatment algorithms include surgery, chemotherapy and targeted therapies. Immunotherapy has recently emerged as an effective treatment approach in several types of cancer, including non–small cell lung cancer, melanoma and kidney cancer. In CRC, novel immune‐checkpoint inhibitors such as anti‐CTLA4 and PD1/PDL1 monoclonal antibodies have shown limited efficacy, although ongoing trials in mismatch repair‐deficient CRC have shown significant and promising results. Here, we review the role of immune‐microenvironment in colorectal cancer and current clinical data about therapeutic activity of immunotherapy in the treatment of CRC.
Part of the book: Colorectal Cancer
Recent advances in immuno-oncology have allowed for the design of more specific and efficient cancer vaccine approaches. There has been an improvement in molecular biology techniques, as well as a greater understanding of the mechanisms involved in the activation and regulation of T cells and the interplay between the components of the immune system and the escape mechanisms used by cancer cells and the tumour microenvironment. As a result, many interesting developments in therapeutic cancer vaccines are ongoing, with influence on survival still to be proven. The spectrum of tumour antigens that are recognised by T cells is still largely unchartered and, most importantly, dynamically evolving over time, driven by clonal evolution and treatment-driven selection. Vaccine approaches currently in development and tested in clinical studies are based on tumour antigens specifically identified for each tumour type, on tumour cells or dendritic cells, the latter having the potential to be modified to incorporate immunostimulatory genes. However, interplay between the immune system and the tumour and the inhibitory mechanisms developed by tumour cells to subvert immune responses are crucial issues that will need to be targeted in order for efficient therapeutic vaccines to emerge.
Part of the book: Cancer Immunotherapy and Biological Cancer Treatments