Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activation

Immunotherapy has emerged as an effective therapeutic approach for several cancer types. However, only a subset of patients exhibits a durable response due in part to immunosuppressive mechanisms that allow tumor cells to evade destruction by immune cells. One of the hallmarks of immune suppression...

Full description

Bibliographic Details
Main Authors: Ginette S. Santiago-Sánchez, James W. Hodge, Kellsye P. Fabian
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Immunology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2022.993624/full
_version_ 1828737222436716544
author Ginette S. Santiago-Sánchez
James W. Hodge
Kellsye P. Fabian
author_facet Ginette S. Santiago-Sánchez
James W. Hodge
Kellsye P. Fabian
author_sort Ginette S. Santiago-Sánchez
collection DOAJ
description Immunotherapy has emerged as an effective therapeutic approach for several cancer types. However, only a subset of patients exhibits a durable response due in part to immunosuppressive mechanisms that allow tumor cells to evade destruction by immune cells. One of the hallmarks of immune suppression is the paucity of tumor-infiltrating lymphocytes (TILs), characterized by low numbers of effector CD4+ and CD8+ T cells in the tumor microenvironment (TME). Additionally, the proper activation and function of lymphocytes that successfully infiltrate the tumor are hampered by the lack of co-stimulatory molecules and the increase in inhibitory factors. These contribute to the imbalance of effector functions by natural killer (NK) and T cells and the immunosuppressive functions by myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs) in the TME, resulting in a dysfunctional anti-tumor immune response. Therefore, therapeutic regimens that elicit immune responses and reverse immune dysfunction are required to counter immune suppression in the TME and allow for the re-establishment of proper immune surveillance. Immuno-oncology (IO) agents, such as immune checkpoint blockade and TGF-β trapping molecules, have been developed to decrease or block suppressive factors to enable the activity of effector cells in the TME. Therapeutic agents that target immunosuppressive cells, either by direct lysis or altering their functions, have also been demonstrated to decrease the barrier to effective immune response. Other therapies, such as tumor antigen-specific vaccines and immunocytokines, have been shown to activate and improve the recruitment of CD4+ and CD8+ T cells to the tumor, resulting in improved T effector to Treg ratio. The preclinical data on these diverse IO agents have led to the development of ongoing phase I and II clinical trials. This review aims to provide an overview of select therapeutic strategies that tip the balance from immunosuppression to immune activity in the TME.
first_indexed 2024-04-12T23:40:21Z
format Article
id doaj.art-57a08a33641348af8a610fb2571dcd57
institution Directory Open Access Journal
issn 1664-3224
language English
last_indexed 2024-04-12T23:40:21Z
publishDate 2022-09-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Immunology
spelling doaj.art-57a08a33641348af8a610fb2571dcd572022-12-22T03:12:00ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-09-011310.3389/fimmu.2022.993624993624Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activationGinette S. Santiago-SánchezJames W. HodgeKellsye P. FabianImmunotherapy has emerged as an effective therapeutic approach for several cancer types. However, only a subset of patients exhibits a durable response due in part to immunosuppressive mechanisms that allow tumor cells to evade destruction by immune cells. One of the hallmarks of immune suppression is the paucity of tumor-infiltrating lymphocytes (TILs), characterized by low numbers of effector CD4+ and CD8+ T cells in the tumor microenvironment (TME). Additionally, the proper activation and function of lymphocytes that successfully infiltrate the tumor are hampered by the lack of co-stimulatory molecules and the increase in inhibitory factors. These contribute to the imbalance of effector functions by natural killer (NK) and T cells and the immunosuppressive functions by myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs) in the TME, resulting in a dysfunctional anti-tumor immune response. Therefore, therapeutic regimens that elicit immune responses and reverse immune dysfunction are required to counter immune suppression in the TME and allow for the re-establishment of proper immune surveillance. Immuno-oncology (IO) agents, such as immune checkpoint blockade and TGF-β trapping molecules, have been developed to decrease or block suppressive factors to enable the activity of effector cells in the TME. Therapeutic agents that target immunosuppressive cells, either by direct lysis or altering their functions, have also been demonstrated to decrease the barrier to effective immune response. Other therapies, such as tumor antigen-specific vaccines and immunocytokines, have been shown to activate and improve the recruitment of CD4+ and CD8+ T cells to the tumor, resulting in improved T effector to Treg ratio. The preclinical data on these diverse IO agents have led to the development of ongoing phase I and II clinical trials. This review aims to provide an overview of select therapeutic strategies that tip the balance from immunosuppression to immune activity in the TME.https://www.frontiersin.org/articles/10.3389/fimmu.2022.993624/fullimmunosuppressioncheckpoint blockadeimmunocytokinebintrafusp alfaNC410costimulatory receptors
spellingShingle Ginette S. Santiago-Sánchez
James W. Hodge
Kellsye P. Fabian
Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activation
Frontiers in Immunology
immunosuppression
checkpoint blockade
immunocytokine
bintrafusp alfa
NC410
costimulatory receptors
title Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activation
title_full Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activation
title_fullStr Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activation
title_full_unstemmed Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activation
title_short Tipping the scales: Immunotherapeutic strategies that disrupt immunosuppression and promote immune activation
title_sort tipping the scales immunotherapeutic strategies that disrupt immunosuppression and promote immune activation
topic immunosuppression
checkpoint blockade
immunocytokine
bintrafusp alfa
NC410
costimulatory receptors
url https://www.frontiersin.org/articles/10.3389/fimmu.2022.993624/full
work_keys_str_mv AT ginettessantiagosanchez tippingthescalesimmunotherapeuticstrategiesthatdisruptimmunosuppressionandpromoteimmuneactivation
AT jameswhodge tippingthescalesimmunotherapeuticstrategiesthatdisruptimmunosuppressionandpromoteimmuneactivation
AT kellsyepfabian tippingthescalesimmunotherapeuticstrategiesthatdisruptimmunosuppressionandpromoteimmuneactivation