Adoptive immunotherapy

The demonstration that the cell-mediated immune response is crucial in the rejection of allogeneic and syngeneic tumours has prompted the use of cells with anti-tumour activity in patients with malignancies—an approach known as adoptive immunotherapy of cancer.

Several strategies have been applied to generate cells with reactivity to tumours, the most common being the production of lymphocyte-activated killer (LAK) cells that can lyse fresh tumour cells, by incubating human peripheral blood lymphocytes with IL-2, ex vivo. The exact mechanism of recognition and destruction of tumours by LAK cells is not fully understood. Trials in renal cell carcinoma and melanoma patients did not reveal any therapeutic advantage in the administration of LAK plus IL-2, compared to monotherapy with IL-2.

In an alternative approach of adoptive immunotherapy, tumour-infiltrating lymphocytes (TILs), that can recognize tumour-associated antigens, have been isolated from human tumours and administered to patients with advanced melanoma, with a response rate (PR + CR) of 25-35%. Recently, genetically manipulated TILs have been produced, with the transduction of the gene encoding either the neomycin phosphotransferase or tumour necrosis factor.

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