Adaptive immune resistance at the tumour site: mechanisms and therapeutic opportunities

TK Kim, EN Vandsemb, RS Herbst… - Nature Reviews Drug …, 2022 - nature.com
Nature Reviews Drug Discovery, 2022nature.com
Tumours employ various tactics to adapt and eventually resist immune attack. These
mechanisms are collectively called adaptive immune resistance (AIR). The first defined and
therapeutically validated AIR mechanism is the selective induction of programmed cell death
1 ligand 1 (PDL1) by interferon-γ in the tumour. Blockade of PDL1 binding to its receptor
PD1 by antibodies (anti-PD therapy) has resulted in remission of a fraction of patients with
advanced-stage cancer, especially in solid tumours. However, many clinical trials combining …
Abstract
Tumours employ various tactics to adapt and eventually resist immune attack. These mechanisms are collectively called adaptive immune resistance (AIR). The first defined and therapeutically validated AIR mechanism is the selective induction of programmed cell death 1 ligand 1 (PDL1) by interferon-γ in the tumour. Blockade of PDL1 binding to its receptor PD1 by antibodies (anti-PD therapy) has resulted in remission of a fraction of patients with advanced-stage cancer, especially in solid tumours. However, many clinical trials combining anti-PD therapy with other antitumour drugs conducted without a strong mechanistic rationale have failed to identify a synergistic or additive effect. In this Perspective article, we discuss why defining AIR mechanisms at the tumour site should be a key focus to direct future drug development as well as practical approaches to improve current cancer therapy.
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