Oncology Meets Immunology: The Cancer-Immunity Cycle
The genetic and cellular alterations that define cancer provide the
immune system with the means to generate T cell responses that recognize
and eradicate cancer cells. However, elimination of cancer by T cells
is only one step in the Cancer-Immunity Cycle, which manages the
delicate balance between the recognition of nonself and the prevention
of autoimmunity. Identification of cancer cell T cell inhibitory
signals, including PD-L1, has prompted the development of a new class of
cancer immunotherapy that specifically hinders immune effector
inhibition, reinvigorating and potentially expanding preexisting
anticancer immune responses. The presence of suppressive factors in the
tumor microenvironment may explain the limited activity observed with
previous immune-based therapies and why these therapies may be more
effective in combination with agents that target other steps of the
cycle. Emerging clinical data suggest that cancer immunotherapy is
likely to become a key part of the clinical management of cancer.
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