Asian Journal of Biomedical and Pharmaceutical Sciences

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Commentary - Asian Journal of Biomedical and Pharmaceutical Sciences (2021) Volume 11, Issue 78

Cancer immunotherapy

Cabral Martin*

Department of Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus

Corresponding Author:
Cabral Martin
Department of Manufacturing Engineering
University of Cyprus
Nicosia
Cyprus
E-mail: [email protected]

Accepted date: June 28, 2021

Description

The widely accepted paradigm of Nano medicine enhanced permeability and retention (EPR) assumes that cytotoxic drugs are often delivered selectively to tumours using Nano medicines defined as drug-loaded nanoparticles to increase efficacy and minimize the danger of systemic adverse effects. However, this approach has thus far conferred only modest improvements within the survival outcomes of patients with cancer. Cancer immunotherapies, including checkpoint inhibitors and adoptive cell therapy, manipulate the system to acknowledge and attack cancer cells. These therapies have the potential to induce durable responses in multiple solid and hematologic malignancies and thus have transformed treatment algorithms for various tumour types. Cancer immunotherapies cause unique toxicity profiles distinct from the toxicities of other cancer therapies, relying on their mechanism of action. These toxicities often require specific management, which can include steroids and immune-modulating therapy which consensus guidelines are published. The system has developed a complicated series of mechanisms to detect and eradicate cancer cells. These pathways protect against the event of malignancy but can promote the selection of tumour cells, which are equipped to avoid the host’s immune response. The concept of cancer immune editing, which highlights the dual role of the system in protecting against tumor growth while also shaping tumor immunogenicity, describes the tactic of tumor development using 3 steps: elimination, equilibrium, and escape. During the elimination phase, the host’s innate and ICIs and CAR-T, have transformed the treatment landscape for multiple solid and hematologic malignancies. Clinical trials still expand the indications for these therapies and to explore new methods of harnessing the system to treat cancer. The growing clinical application of immunotherapy highlights the importance of the recognition and management of its unique toxicity profile. Further studies are needed to develop risk stratification models and to characterize the pathophysiology leading to toxicity, which may improve current preventive and treatment approaches. The cornerstone of toxicity management is typically steroids or immunosuppression, and on-going studies are evaluating the effect of immune suppression on antitumor efficacy adaptive immune systems recognize and answer tumor-specific antigens. Some tumor cells survive elimination and enter the equilibrium phase, during which the adaptive system prevents outright tumor growth but exerts a selective pressure on the remaining malignant clones. Tumor cells escape once they develop resistance to the antitumor immune response. Multiple mechanisms are described to account for the evolution of this escape, including alteration or loss of antigens, manipulation of cytokine expression, and up regulation of immune checkpoint proteins. Cancer immunotherapies, which were developed supported studies of the mechanisms of tumor escape, manipulate the system to reactivate the antitumor immune response and overcome the pathways leading to escape. Early approaches to cancer immunotherapy targeted cytokines to affect immune cell function. Therapeutic approaches to manage multiple aspects of the system have subsequently been investigated, including immune checkpoint inhibitors (ICIs), adoptive cell therapy, oncolytic viruses, and cancer vaccines. Immunotherapies have transformed the treatment landscape for multiple solid and hematologic malignancies but confer unique toxicity profiles, which vary relying on the type of immunotherapy and are related to the precise mechanism of action. Endocrinopathies associated with ICI include hypothyroidsm or hyperthyroidism, thyroiditis, hypophysitis, primary adrenal insufficiency, and insulin-dependent DM. The pattern of Endocrinopathies varies by agent, with the absolute best incidence after combination therapy.

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