Engaging the immune response: a unique approach to cancer management

Cancer immunotherapy strategies are designed to engage the immune system against tumours. This approach is unique in the oncology setting and introduces new considerations for cancer management.1,2

PROPOSED ASPECTS OF THE IMMUNE RESPONSE3

  • TARGETED

    to tumour-specific antigens

  • RAPID

    activation of the immune response

  • ADAPTABLE

    as the tumour mutates and evolves

  • SELF-PROPAGATING

    with each revolution of the cancer immunity cycle

  • DURABLE

    response over time

Considerations for a durable antitumour effect

Duration of response

The immune response has the ability to adapt with cancer as it evolves, and can become self-propagating once the cancer immunity cycle is initiated. Immune-directed strategies aim to leverage these attributes, with the goal of inducing a durable antitumour effect.3-5

Pseudo-progression

T-cell infiltration to the tumour site may cause an apparent increase in tumour size or the appearance of new lesions. This inflammatory effect can be misinterpreted as progressive disease, as it can be difficult to differentiate the different cell types in radiographic imaging. New criteria have been developed to better capture immune-related response patterns, and may guide evaluation of immunotherapies in clinical trials, and potentially in clinical care.1,2,6

T cell infiltration to tumour site
T cell infiltration to tumour site

Immune-related adverse events

While the goal of cancer immunotherapy research is to understand how to activate specific components of the immune response, the potential for off-target effects exists. Adverse event profiles may vary among different immune-directed strategies. As strategies grow more targeted, the recognition and management of immune-related adverse events will evolve.1,3