January 19, 2017 (Discovery Medicine)
Sarcomas are rare and aggressive malignancies of bone and soft tissue affecting all ages of patients that are usually incurable when non-responsive to chemotherapy and surgery. Most sarcomas exhibit immune response, but the microenvironment and the tumor tend to be immunosuppressive. The work on new immunotherapies strives to revert immunosuppressive conditions and activate the antitumor immunity.
Discovery Medicine presents a systematic review that covers the available literature on the sarcoma immune microenvironment. It includes the following topics:
1. Introduction to sarcomas, rare cancers of bones and soft tissues.
2. Overview of antitumor immunity and potential targets for intervention. It is believed that cancer cells are initially recognized and destroyed by the immune system. However, over time, cancer cells can become immunoresistant. In order for immunity to work, there must be a highly complex interplay between tumor specific neoantigens, robust antigen presentation, induction of t-cells, migration of t-cells into the tumor, and maintenance of the immune response.
3. Understanding the immune microenvironment in sarcoma. After an extensive review of the current studies, the authors conclude that there are still unanswered questions involving sarcoma and modern immunotherapy. There is a lack of data, and where there is data, some of the results are poor or even conflicting. However, there is support for the continuing study of tolerance of immunotherapy in sarcoma.
4. Boosting neoantigen production and recognition. Determining ways to boost neoantigens are a critical area of study.
5. Rebalancing the tumor microenvironment to promote a robust antigen presentation.
6. Using adoptive t-cell therapy to by pass the roadblcocks of immunotherapy.
7. How checkpoint inhibitors have changed the landscape of immunotherapy. However, combinations of checkpoint inhibitors must be used for sarcomas because of the complex nature of the sarcoma microenvironment.
Read the complete systematic review “From Vision to Reality: Deploying the Immune System for Treatment of Sarcoma” on Discovery Medicine.
