For many years, scientists have tried – and failed – to develop techniques to activate the body’s immune system against cancer. The majority of these immunotherapy approaches, especially vaccines, simply didn’t have enough potency, or were based on a weak target that had little impact on advanced disease. The rationale for vaccines in cancer prevention is much stronger, as we have seen with the HPV vaccines, Gardasil and Cervarix, for example. When given to patients with advanced disease, the large tumour burden is usually too much for them to overcome and the cancer wins.
Although the immunotherapy field in oncology has been largely a graveyard with millions of dollars wasted and lost, there have been some notable successes. US approvals include rituximab (and other similar CD20 targeted antibodies) in B-cell malignancies, the IMiDs (thalidomide, lenalidomide, pomalidomide) in multiple myeloma, and ipilimumab, a human cytotoxic T-lymphocyte antigen 4 (CTLA4) antibody in metastatic melanoma.
There are several interesting challenges with immunotherapies that must be overcome before successful therapeutics can be developed.
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