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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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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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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 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.
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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Area of Science:

  • Oncology
  • Immunology
  • Gastroenterology

Background:

  • Gastrointestinal (GI) cancers encompass a range of malignancies including esophageal, gastric, pancreatic, hepatobiliary, and colorectal.
  • Immunotherapy has emerged as a critical treatment modality in oncology, with recent evaluations for various GI malignancies.

Purpose of the Study:

  • To review current immunotherapies under investigation for GI cancers.
  • To discuss the mechanisms, clinical trial outcomes, achievements, and limitations of these treatments.

Main Methods:

  • Review of recent clinical trials focusing on immunotherapy for GI cancers.
  • Analysis of treatment efficacy, particularly overall survival.
  • Discussion of emerging immunotherapy classes and biomarkers.

Main Results:

  • Immunotherapy demonstrates efficacy in microsatellite instability-high colorectal cancer.
  • Some promise is observed in gastroesophageal junction and gastric cancers.
  • Limited effectiveness is noted for pancreatic and neuroendocrine tumors.

Conclusions:

  • Immunotherapy for GI cancers is an evolving field with significant potential.
  • Biomarker identification is crucial for personalized therapy selection.
  • Development of novel immune therapies beyond PD-1/PD-L1 inhibitors is ongoing.