Imaging in Tumor Immunology.

Hiroshi Shiku, MD, PhD: In Memoriam (1943–2022)

Cancer immunotherapy has flourished over the last 10–15 years, transforming the practice of oncology and providing long-term clinical benefit to some patients. During this time, three distinct classes of immune...

A personalized view on cancer immunotherapy

The human body and its microbiome constitute a highly delicate system. The gut microbiome participates in the absorption of the host’s nutrients and metabolism, maintains the microcirculation, and modulates the immune response. Increasing evidence shows that gut microbiome dysbiosis in the body not only affects the occurrence and development of tumors but also tumor prognosis and treatment. Microbiome have been implicated in tumor control in patients undergoing anti- angiogenesis therapy and immunotherapy. In cases with unsatisfactory responses to chemotherapy, radiotherapy, and targeted therapy, appropriate adjustment of microbes abundance is considered to enhance the treatment response. Here, we review the current research progress in cancer immunotherapy and anti- angiogenesis therapy, as well as the unlimited potential of their combination, especially focusing on how the interaction between intestinal microbiota and the immune system affects cancer pathogenesis and treatment. In addition, we discuss the effects of microbiota on anti-cancer immune response and anti- angiogenesis therapy, and the potential value of these interactions in promoting further research in this field.

Emerging Role and Future Directions of Immunotherapy in Advanced Ovarian Cancer

Immunotherapy: A breakthrough in cancer research

Immunotherapy and tumor microenvironment

Recent advancements in understanding how cancer cells evade immune recognition have led to significant progress in cancer immunotherapy. Therapeutic cancer vaccines hold great promise due to their safety, specificity, and ability to establish lasting immune memory, serving as an effective immunotherapy either alone or in combination with other treatments in clinical research. Cancer vaccines aim to restore the host’s innate and adaptive anti-cancer immune responses by stimulating antigen-presenting processes and reversing the immunosuppressive environment that facilitates tumor immune evasion and metastasis. Although in clinical studies cancer vaccines have been observed to not effectively induce tumor regression, they can enhance local immune responses in combination with other immunotherapeutic agents, such as immune checkpoint inhibitors (ICIs), thus delaying cancer recurrence and prolonging overall survival in advanced tumor settings.

Recent progress in cancer immunotherapy has been remarkable, especially the clinical development of immune checkpoint inhibitors, such as anti-CTLA-4 and anti-PD-1 antibodies. The success of these agents has revealed the importance of anti-tumor immune activities in curing cancers. Cancer peptide vaccines constitute another approach to eliciting and boosting anti-tumor immune responses. While conventional cancer vaccines have had limited clinical efficacy, targeting mainly tumor-associated selfantigens, a novel approach is now being explored to target tumor-specific antigens generated from gene mutations occurring in tumor cells during neoplastic transformation. Theoretically, immune responses to these so-called “cancer neoantigens” are not attenuated by host central tolerance in the thymus and do not trigger autoimmune reactions. Despite these theoretical considerations, until recently there were major technical difficulties in applying neoantigen-based cancer vaccines to bedside practice, because the mutations in each tumor are so numerous and which one/subset of neoantigens would be immunogenic enough to eliminate the tumor is uncertain. Recent developments in genomics and bioinformatics, including massively parallel sequencing (MPS) and epitope prediction algorithms, have provided a major breakthrough, enabling more comprehensive and efficient identification of target antigens. Although further refinements are needed for actual bedside application, the preclinical and clinical evidence for the effectiveness of targeting cancer neoantigens continues to accumulate. In this review, we discuss the current status and future challenges of developing neoantigen-based personalized immunotherapy.

ABSTRACT/INTRODUCTION Tumor immunology and cancer immunotherapy is a growing field, continuously evolving. Different types of immunotherapies have been implemented over last decade in the standard of care across several tumor types. Novel strategies to overcome resistance or to tackle the tumor microenvironment are currently at the forefront of the tumor immunology and cancer immunotherapies research. The Spanish Group for Cancer Immuno-Biotherapies (GÉTICA) held the IX Forum on Translational Immunology and Cancer Immunotherapy (FITCancer 9) from 9-11 March, in Madrid (Spain). FITCancer, which is the largest meeting uniquely focused on cancer immunotherapy, brings together clinicians and researchers, experts in the field of cancer immunology and immunotherapy. Here, we present abstracts submitted by GÉTICA’s members to the IX Forum on Translational Immunology and Cancer Immunotherapy.

The past two decades have brought impressive advancements in immune modulation, particularly with the advent of both cancer immunotherapy and biologic therapeutics for inflammatory conditions. However, the dynamic nature of the immune response often complicates the assessment of therapeutic outcomes. Innovative imaging technologies are designed to bridge this gap and allow non-invasive visualization of immune cell presence and/or function in real time. A variety of anatomical and molecular imaging modalities have been applied for this purpose, with each option providing specific advantages and drawbacks. Anatomical methods including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound provide sharp tissue resolution, which can be further enhanced with contrast agents, including super paramagnetic ions (for MRI) or nanobubbles (for ultrasound). Conjugation of the contrast material to an antibody allows for specific targeting of a cell population or protein of interest. Protein platforms including antibodies, cytokines, and receptor ligands are also popular choices as molecular imaging agents for positron emission tomography (PET), single-photon emission computerized tomography (SPECT), scintigraphy, and optical imaging. These tracers are tagged with either a radioisotope or fluorescent molecule for detection of the target. During the design process for immune-monitoring imaging tracers, it is important to consider any potential downstream physiologic impact. Antibodies may deplete the target cell population, trigger or inhibit receptor signaling, or neutralize the normal function(s) of soluble proteins. Alternatively, the use of cytokines or other ligands as tracers may stimulate their respective signaling pathways, even in low concentrations. As in vivo immune imaging is still in its infancy, this review aims to describe the modalities and immunologic targets that have thus far been explored, with the goal of promoting and guiding the future development and application of novel imaging technologies.

ABSTRACTIntroduction: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with >500,000 cases diagnosed each year. HNSCC patients often present to the clinic with advanced disease and are managed with a multi-disciplinary approach consisting of surgery, chemotherapy, and/or radiation. Morbidity and quality of life issues are major challenges in this patient population due to the debilitating effects of standard of care treatment paradigms. There is a critical need for new therapeutic approaches to manage HNSCC with better anti-tumor activities and toxicity profiles. Immunotherapy has gained traction as a precision medicine initiative to manage solid malignancies.Areas covered: The authors review current knowledge of immune escape mechanisms and discuss key immunotherapies in HNSCC with an emphasis on clinical trials data.Expert opinion: The excitement over the potential of immunotherapy to manage solid malignancies, including HNSCC is high and warranted based on the impressive clinical data accrued to date. Research in immunity and immune modulation in cancer has been invigorated and offers the potential to reveal novel vulnerabilities that may be exploitable pharmacologically. The evolution of immunotherapy will continue and move toward rational combinations with other immunotherapies or molecularly-targeted agents in the first-line, adjuvant, and recurrent/metastatic settings in HNSCC.

A role for vitamin D in immune modulation and in cancer has been suggested. In this work, we report that mice with increased availability of vitamin D display greater immune-dependent resistance to transplantable cancers and augmented responses to checkpoint blockade immunotherapies. Similarly, in humans, vitamin D-induced genes correlate with improved responses to immune checkpoint inhibitor treatment as well as with immunity to cancer and increased overall survival. In mice, resistance is attributable to the activity of vitamin D on intestinal epithelial cells, which alters microbiome composition in favor of Bacteroides fragilis, which positively regulates cancer immunity. Our findings indicate a previously unappreciated connection between vitamin D, microbial commensal communities, and immune responses to cancer. Collectively, they highlight vitamin D levels as a potential determinant of cancer immunity and immunotherapy success.

The 19th Annual Meeting of the Association for Cancer Immunotherapy (CIMT), Europe’s cancer immunotherapy meeting, was the first in-person event organized by CIMT since the beginning of the COVID-19 pandemic. As a hybrid event from May 10–12, the meeting attracted 920 academic and clinical professionals from over 40 countries, who met to discuss the latest advances in cancer immunology and immunotherapy research. This report summarizes the highlights of CIMT2022.

Advances in Immunogenic Cell Death for Cancer Immunotherapy