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Tumor Immunotherapy

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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Cancer treatment vaccines are a rapidly evolving field that offers a promising approach to immunotherapy. Unlike traditional vaccines that prevent diseases, cancer treatment vaccines are designed to treat existing cancers by stimulating the immune system to recognize and attack cancer cells.
Cancer vaccines come in two categories: preventive (prophylactic) and treatment (active). Preventive vaccines, such as the Human Papillomavirus (HPV) vaccine, protect against viruses that cause certain...
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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
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Cancer Therapies02:49

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Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Immunotherapy in Gastric Cancer.

Anica Högner1, Markus Moehler2

  • 1Campus Virchow-Klinikum, Medizinische Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany.

Current Oncology (Toronto, Ont.)
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Summary

Immune checkpoint inhibitors are revolutionizing advanced gastric cancer treatment. Combinations with chemotherapy and targeted therapies show improved survival across various treatment lines.

Keywords:
CTLA-4Her2-positivePD-1PD-L1checkpoint inhibitionesophagogastric cancergastric cancerimmunotherapytrastuzumab

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Area of Science:

  • Oncology
  • Immunotherapy
  • Gastrointestinal Oncology

Background:

  • Immune checkpoint inhibitors (ICIs) represent a significant advancement in treating advanced or metastatic gastric cancer (GC).
  • ICIs are being investigated in combination with chemotherapy and other targeted therapies across all lines of treatment for GC, gastroesophageal junction cancer (GEJC), and esophageal cancer (EC).

Purpose of the Study:

  • To review the rationale and current results of clinical trials involving immune checkpoint inhibitors targeting PD-L1/1 and CTLA-4 in GC.
  • To summarize the efficacy of these agents in combination with chemotherapy and Her2-targeted therapy.

Main Methods:

  • Review of Phase II and III clinical trials.
  • Analysis of data from key trials such as CHECKMATE-649, KEYNOTE-590, KEYNOTE-811, ATTRACTION-02, and KEYNOTE-059.
  • Focus on immune checkpoint inhibitors targeting PD-L1/1 and CTLA-4.

Main Results:

  • First-line nivolumab plus chemotherapy improves overall survival (OS) in PD-L1-positive advanced GC, GEJC, and EC (e.g., CHECKMATE-649, KEYNOTE-590).
  • Pembrolizumab plus trastuzumab and chemotherapy is approved for first-line treatment of HER2-positive tumors (e.g., KEYNOTE-811).
  • Nivolumab shows superior OS in third-line therapy regardless of PD-L1 status, and pembrolizumab prolongs response duration in PD-L1 positive patients.

Conclusions:

  • Immune checkpoint inhibition, in various combinations, is a new standard of care for advanced GC, GEJC, and EC.
  • Combinations with chemotherapy and targeted therapies demonstrate significant improvements in overall survival and duration of response.
  • Ongoing clinical trials continue to explore the optimal use of ICIs in different therapeutic settings for gastrointestinal cancers.