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Related Concept Videos

Tumor Immunotherapy01:27

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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Preoperative Immunotherapy in Oncology.

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    Neoadjuvant immune checkpoint inhibitors (ICI) improve survival in breast, lung, and esophagogastric cancers. For rectal cancer, ICI therapy can lead to complete remission, potentially avoiding surgery.

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    Area of Science:

    • Oncology
    • Immunotherapy
    • Surgical Oncology

    Background:

    • Immune checkpoint inhibitors (ICI) are established treatments for metastatic cancers.
    • Preoperative (neoadjuvant) ICI use is increasingly studied to improve survival outcomes.
    • Research focuses on ICI efficacy in various solid tumors before surgical intervention.

    Purpose of the Study:

    • To review the efficacy of neoadjuvant immune checkpoint inhibitors (ICI) in specific cancers.
    • To evaluate ICI's impact on event-free survival (EFS) and overall survival (OS) before surgery.
    • To assess current approvals and future potential of neoadjuvant ICI therapy.

    Main Methods:

    • Systematic review of clinically relevant studies published since 2018.
    • Focused search on PubMed for neoadjuvant ICI in breast, NSCLC, colorectal, and esophagogastric cancers.
    • Inclusion of international conference abstracts for comprehensive data.

    Main Results:

    • Durvalumab plus chemotherapy is standard for stage IIa+ triple-negative breast cancer, improving 5-year EFS by 9% and OS by 5%.
    • In NSCLC (stage II/III), neoadjuvant ICI with chemotherapy increased 2-year EFS by ~11%.
    • Esophagogastric adenocarcinoma (stage II/III) saw an 8% increase in 2-year EFS with durvalumab and chemotherapy; rectal cancer with MSI showed high complete remission rates (50-100%), potentially obviating surgery.

    Conclusions:

    • Neoadjuvant ICI therapy is becoming standard or is nearing approval for certain cancers.
    • Management of ICI-related toxicity requires careful attention.
    • Biomarker identification is crucial for predicting patient response and optimizing ICI use, considering adverse effects and cost.