Cryoimmunotherapy

Last updated

Cryoimmunotherapy, also referred to as cryoimmunology, is an oncological treatment for various cancers that combines cryoablation of tumor with immunotherapy treatment. [1] In-vivo cryoablation of a tumor, alone, can induce an immunostimulatory, systemic anti-tumor response, resulting in a cancer vaccine—the abscopal effect. [2] Thus, cryoablation of tumors is a way of achieving autologous, in-vivo tumor lysate vaccine and treat metastatic disease. [3] [4] However, cryoablation alone may produce an insufficient immune response, depending on various factors, such as high freeze rate. [5] Combining cryotherapy with immunotherapy enhances the immunostimulating response and has synergistic effects for cancer treatment. [6]

Contents

Although, cryoblation and immunotherapy has been used successfully in oncological clinical practice for over 100 years, [7] [8] and can treat metastatic disease with curative intent, it has been ignored in modern practice. Only recently has cryoimmunotherapy been resurrected to become the gold standard in cancer treatment of all stages of disease. [9]

History

Immunological effects resulting from the cryoablation of tumors was first observed in the 1960s. [10] [11] Since the 1960s, Tanaka treated metastatic breast cancer patients with cryotherapy and reported cryoimmunological reaction resulting from cryotherapy. [12] [13] In the 1970s, systemic immunological response from local cryoablation of prostate cancer was also clinically observed. [14] [15] [16] In the 1980s, Tanaka, of Japan, continued to advance the clinical practice of cryoimmunology with combination treatments including: cryochemotherapy and cryoimmunotherapy. [17] In 1997, Russian scientists confirmed the efficacy of cryoimmunotherapy in inhibiting metastases in advanced cancer. [18] In 2000s, China, following closely with the exciting developments, enthusiastically embraced cryoablation treatment for cancer and has been leading the practice ever since with cryoimmunotherapy treatments available for cancer patients in numerous hospitals and medical clinics throughout China. [19] [20] In the 2010s, American researchers and medical professionals, started to explore cryoimmunotherapy for systemic treatment of cancer. [21]

Mechanisms of actions

Cryoablation of tumor induces necrosis of tumor cells. The immunotherapeutic effect of cryoablation of tumor is the result of the release of intracellular tumor antigens from within the necrotized tumor cells. The released tumor antigens help activate anti-tumor T cells, which destroy remaining malignant cells. Thus, cryoablation of tumor elicits a systemic anti-tumor immunologic response. [22] [23] [24]

The resulting immunostimulation from cryoablation may not be sufficient to induce sustained, systemic regression of metastases, and can be synergised with the combination of immunotherapy treatment and vaccine adjuvants. [25]

Various adjuvant immunotherapy and chemotherapy treatments can be combined with cryoablation to sustain systemic anti-tumor response with regression of metastases, including:

See also

Related Research Articles

<span class="mw-page-title-main">Metastasis</span> Spread of a disease inside a body

Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, then, are metastases (mets). It is generally distinguished from cancer invasion, which is the direct extension and penetration by cancer cells into neighboring tissues.

Immunotherapy or biological therapy is the treatment of disease by activating or suppressing the immune system. Immunotherapies designed to elicit or amplify an immune response are classified as activation immunotherapies, while immunotherapies that reduce or suppress are classified as suppression immunotherapies. Immunotherapy is under preliminary research for its potential to treat various forms of cancer.

<span class="mw-page-title-main">Cancer immunotherapy</span> Artificial stimulation of the immune system to treat cancer

Cancer immunotherapy (immuno-oncotherapy) is the stimulation of the immune system to treat cancer, improving the immune system's natural ability to fight the disease. It is an application of the fundamental research of cancer immunology (immuno-oncology) and a growing subspecialty of oncology.

<span class="mw-page-title-main">RANKL</span> Mammalian protein found in Homo sapiens

Receptor activator of nuclear factor kappa-Β ligand (RANKL), also known as tumor necrosis factor ligand superfamily member 11 (TNFSF11), TNF-related activation-induced cytokine (TRANCE), osteoprotegerin ligand (OPGL), and osteoclast differentiation factor (ODF), is a protein that in humans is encoded by the TNFSF11 gene.

<span class="mw-page-title-main">Cryoablation</span> Process using extreme cold to destroy tissue

Cryoablation is a process that uses extreme cold to destroy tissue. Cryoablation is performed using hollow needles (cryoprobes) through which cooled, thermally conductive fluids are circulated. Cryoprobes are positioned adjacent to the target in such a way that the freezing process will destroy the diseased tissue. Once the probes are in place, the attached cryogenic freezing unit removes heat from ("cools") the tip of the probe and by extension from the surrounding tissues.

<span class="mw-page-title-main">Ipilimumab</span> Pharmaceutical drug

Ipilimumab, sold under the brand name Yervoy, is a monoclonal antibody medication that works to activate the immune system by targeting CTLA-4, a protein receptor that downregulates the immune system.

Chemoimmunotherapy is chemotherapy combined with immunotherapy. Chemotherapy uses different drugs to kill or slow the growth of cancer cells; immunotherapy uses treatments to stimulate or restore the ability of the immune system to fight cancer. A common chemoimmunotherapy regimen is CHOP combined with rituximab (CHOP-R) for B-cell non-Hodgkin lymphomas.

<span class="mw-page-title-main">Tumor-infiltrating lymphocytes</span>

Tumor-infiltrating lymphocytes (TIL) are white blood cells that have left the bloodstream and migrated towards a tumor. They include T cells and B cells and are part of the larger category of ‘tumor-infiltrating immune cells’ which consist of both mononuclear and polymorphonuclear immune cells, in variable proportions. Their abundance varies with tumor type and stage and in some cases relates to disease prognosis.

<span class="mw-page-title-main">Bone metastasis</span> Medical condition

Bone metastasis, or osseous metastatic disease, is a category of cancer metastases that result from primary tumor invasions into bones. Bone-originating primary tumors such as osteosarcoma, chondrosarcoma, and Ewing sarcoma are rare; the most common bone tumor is a metastasis. Bone metastases can be classified as osteolytic, osteoblastic, or both. Unlike hematologic malignancies which originate in the blood and form non-solid tumors, bone metastases generally arise from epithelial tumors and form a solid mass inside the bone. Bone metastases, especially in a state of advanced disease, can cause severe pain, characterized by a dull, constant ache with periodic spikes of incident pain.

<span class="mw-page-title-main">Metastatic breast cancer</span> Type of cancer

Metastatic breast cancer, also referred to as metastases, advanced breast cancer, secondary tumors, secondaries or stage IV breast cancer, is a stage of breast cancer where the breast cancer cells have spread to distant sites beyond the axillary lymph nodes. There is no cure for metastatic breast cancer; there is no stage after IV.

<span class="mw-page-title-main">Brain metastasis</span> Cancer that has metastasized (spread) to the brain from another location in the body

A brain metastasis is a cancer that has metastasized (spread) to the brain from another location in the body and is therefore considered a secondary brain tumor. The metastasis typically shares a cancer cell type with the original site of the cancer. Metastasis is the most common cause of brain cancer, as primary tumors that originate in the brain are less common. The most common sites of primary cancer which metastasize to the brain are lung, breast, colon, kidney, and skin cancer. Brain metastases can occur months or even years after the original or primary cancer is treated. Brain metastases have a poor prognosis for cure, but modern treatments allow patients to live months and sometimes years after the diagnosis.

Pelareorep is a proprietary isolate of the unmodified human reovirus being developed as a systemically administered immuno-oncological viral agent for the treatment of solid tumors and hematological malignancies. Pelareorep is an oncolytic virus, which means that it preferentially lyses cancer cells. Pelareorep also promotes an inflamed tumor phenotype through innate and adaptive immune responses. Preliminary clinical trials indicate that it may have anti-cancer effects across a variety of cancer types when administered alone and in combination with other cancer therapies.

Neuvenge, Lapuleucel-T, is a therapeutic cancer vaccine (TCV) in development by Dendreon (DNDN). It uses the "immunotherapy platform approach" first successfully demonstrated on the U.S. Food and Drug Administration (FDA)-approved TCV Provenge. It was first tested on breast cancer patients with tumors expressing HER2/neu, and is now scheduled to be tested on bladder cancer patients.

<span class="mw-page-title-main">Abscopal effect</span> Hypothesis in the treatment of metastatic cancer

The abscopal effect is a hypothesis in the treatment of metastatic cancer whereby shrinkage of untreated tumors occurs concurrently with shrinkage of tumors within the scope of the localized treatment. R.H. Mole proposed the term “abscopal” in 1953 to refer to effects of ionizing radiation “at a distance from the irradiated volume but within the same organism.”

<span class="mw-page-title-main">Pembrolizumab</span> Pharmaceutical drug used in cancer treatment

Pembrolizumab, sold under the brand name Keytruda, is a humanized antibody used in cancer immunotherapy that treats melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, stomach cancer, cervical cancer, and certain types of breast cancer. It is administered by slow intravenous injection.

PROSTVAC is a cancer immunotherapy candidate in clinical development by Bavarian Nordic for the treatment of all prostate cancer although clinical trials are focusing on more advanced cases of metastatic castration-resistant prostate cancer (mCRPC). PROSTVAC is a vaccine designed to enable the immune system to recognize and attack prostate cancer cells by triggering a specific and targeted T cell immune response to cancer cells that express the tumor-associated antigen prostate-specific antigen (PSA).

Interventional oncology is a subspecialty field of interventional radiology that deals with the diagnosis and treatment of cancer and cancer-related problems using targeted minimally invasive procedures performed under image guidance. Interventional oncology has developed to a separate pillar of modern oncology and it employs X-ray, ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) to help guide miniaturized instruments to allow targeted and precise treatment of solid tumours located in various organs of the human body, including but not limited to the liver, kidneys, lungs, and bones. Interventional oncology treatments are routinely carried out by interventional radiologists in appropriate settings and facilities.

This is a historical timeline of the development and progress of cancer treatments, which includes time of discovery, progress, and approval of the treatments.

Combinatorial ablation and immunotherapy is an oncological treatment that combines various tumor-ablation techniques with immunotherapy treatment. Combining ablation therapy of tumors with immunotherapy enhances the immunostimulating response and has synergistic effects for curative metastatic cancer treatment. Various ablative techniques are utilized including cryoablation, radiofrequency ablation, laser ablation, photodynamic ablation, stereotactic radiation therapy, alpha-emitting radiation therapy, hyperthermia therapy, HIFU. Thus, combinatorial ablation of tumors and immunotherapy is a way of achieving an autologous, in-vivo tumor lysate vaccine and treating metastatic disease.

The dendritic cell-based cancer vaccine is an innovation in therapeutic strategy for cancer patients.

References

  1. ↑ Sidana Abhinav (2014). "Cancer immunotherapy using tumor cryoablation". Immunotherapy. 6 (1): 85–93. doi:10.2217/imt.13.151. PMID   24341887.
  2. ↑ Tarkowski R, Rzaca M (2005). "Immunologic response to cryoablation of breast cancer". Gland Surg. 3 (2): 88–93. doi:10.3978/j.issn.2227-684X.2014.03.04. PMC   4115762 . PMID   25083502.
  3. ↑ Conway, Sarah (2016-03-02). "Harnessing ultrasound-guided cryoablation for breast cancer". Applied Radiology. Retrieved 2024-08-06.
  4. ↑ Tsuchiya, Hiroyuki; Namiki, Mikio; Mizokami, Atsushi; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Hayashi, Katsuhiro; Shirai, Toshiharu; Nishida, Hideji (2011). "Cryotreatment against Metastatic Renal Cell Bone Tumour Reduced Multiple Lung Metastases". Anticancer Research. 31 (9): 2927–2930. PMID   21868540.
  5. ↑ Sabel MS, Su G, Griffith KA, Chang AE (2010). "Rate of freeze alters the immunologic response after cryoablation of breast cancer". Annals of Surgical Oncology. 17 (4): 1187–1193. doi:10.1245/s10434-009-0846-1. PMID   20033323. S2CID   30048369.
  6. ↑ Haen, SP; Pereira, PL; Salih, HR; Rammensee, HG; Gouttefangeas, C (2011). "More Than Just Tumor Destruction: Immunomodulation by Thermal Ablation of Cancer". Clin Dev Immunol. 2011: 1–19. doi: 10.1155/2011/160250 . PMC   3254009 . PMID   22242035.
  7. ↑ History of Cryosurgery. 2008.
  8. ↑ McCarthy EF (2006). "The Toxins of William B. Coley and the Treatment of Cancer". Iowa Orthop J. 26: 154–8. PMC   1888599 . PMID   16789469.
  9. ↑ "About Cryotherapy".
  10. ↑ Mehta Amol (2016). "Thermal Ablative Therapies and Immune Checkpoint Modulation: Can Locoregional Approaches Effect a Systemic Response". Gastroenterol Res Pract. 2016: 1–11. doi: 10.1155/2016/9251375 . PMC   4802022 . PMID   27051417.
  11. ↑ Yantorno C, Soanes WA, Gonder MJ, Shulman S (1967). "Studies in cryo-immunology". Immunology. 12 (4): 395–410. PMC   1409203 . PMID   4960713.
  12. ↑ Tanaka (1982). "Immunological aspects of cryosurgery in general surgery". Cryobiology. 19 (3): 247–62. doi:10.1016/0011-2240(82)90151-1. PMID   7105777.
  13. ↑ Richard J. Ablin (1998). "The Use of Cryosurgery for Breast Cancer". Arch Surg. 133 (1): 106. doi:10.1001/archsurg.133.1.106. PMID   9438770.
  14. ↑ Soanes WA, Ablin RJ, Gonder MJ (1970). "Remission of metastatic lesions following cryosurgery in prostatic cancer: immunologic considerations". J Urol. 104 (1): 154–9. doi:10.1016/s0022-5347(17)61690-2. PMID   4987666.
  15. ↑ Ablin, Richard J.; Fontana, Gabriele (1979). "Cryoimmunotherapy: Continuing Studies toward Determining a Rational Approach for Assessing the Candidacy of the Prostatic Cancer Patient for Cryoimmunotherapy and Postoperative Responsiveness". Eur Surg Res. 11 (4): 223–233. doi:10.1159/000128070. PMID   527611.
  16. ↑ R. J. Ablin; et al. (1971). "Prospects for Cryo-Immunotherapy in Cases of Metastasizing Carcinoma of the Prostate". Cryobiology. 8 (3): 271–279. doi:10.1016/0011-2240(71)90050-2. PMID   5570410.
  17. ↑ Tanaka (1985). "Cryotherapy" (in general surgery and related areas).". Gan No Rinsho. 31 (6 Suppl): 712–20. PMID   3897620.
  18. ↑ Vladimir Mouraviev, M.D (1997). "THE GUIDED CRYOIMMUNOTHERAPY IN THE ADVANCED PROSTATE CANCER".
  19. ↑ "China: New Chair of the International Society of Cryosurgery (ISC)". 2015. Archived from the original on 2016-10-20. Retrieved 2016-10-20.
  20. ↑ "Minimally Invasive Breast Cancer Cryotherapy Largely Ignored in U.S., Says Advocate and 13-Year Survivor". 2016. Archived from the original on 2016-10-20. Retrieved 2016-10-20.
  21. ↑ Veenstra JJ, Gibson HM, Freytag S, Littrup PJ, Wei WZ (2015). "In situ immunization via non-surgical ablation to prevent local and distant tumor recurrence". Oncoimmunology. 4 (3): e989762. doi:10.4161/2162402X.2014.989762. PMC   4404795 . PMID   25949901.
  22. ↑ Xu, Lisa X.; Liu, Ping; He, Kun; Zhang, Aili; Zhang, Yan; Zhu, Jun (2015). "Cryo-thermal therapy elicits potent anti-tumor immunity". Scientific Reports. 6: 27136. doi:10.1038/srep27136. PMC   4891716 . PMID   27256519.
  23. ↑ Cryosurgery initiates inflammation and leaves tumor-specific antigens intact, which may induce an anti-tumor immune response.Sabel (2005). "Immunologic response to cryoablation of breast cancer". Gland Surg. 3 (2): 88–93. doi:10.3978/j.issn.2227-684X.2014.03.04. PMC   4115762 . PMID   25083502.
  24. ↑ Machlenkin, A.; Goldberger, O.; Tirosh, B.; Paz, A.; Volovitz, I.; Bar-Haim, E.; Lee, S. H.; Vadai, E.; Tzehoval, E.; Eisenbach, L. (2005). "Combined Dendritic Cell Cryotherapy of Tumor Induces Systemic Antimetastatic Immunity". Clinical Cancer Research. 11 (13): 4955–4961. doi: 10.1158/1078-0432.CCR-04-2422 . PMID   16000595.
  25. ↑ Mehta Amol (2016). "Thermal Ablative Therapies and Immune Checkpoint Modulation: Can Locoregional Approaches Effect a Systemic Response". Gastroenterol Res Pract. 2016: 1–11. doi: 10.1155/2016/9251375 . PMC   4802022 . PMID   27051417.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.