Immunotherapy

Personalized cancer treatment is a central goal of modern oncology. The fact that the immune system can detect virtually an unlimited number of antigens makes immunotherapy by definition a personalized therapeutic agent.

The immune system is so regulated by nature that it distinguishes its own organism, the "self," from the foreigner, as shown, for example, by the study of immune responses in microbes. In addition, a healthy and prosperous immune system has the ability to recognize itself from the "modified self", which is the case with cancer. After all, this is why not everyone suffers from cancer: Any cell that deviates from the normal, is detected and destroyed. However, many of the immune system's mechanisms for controlling and inhibiting autoimmune responses are "usurped" by cancer, and it manages to use them effectively to survive. In this way it "hides" and goes unnoticed by the immune system.

Understanding the interaction of cancer with the immune system has begun to pay off in practice. Today, our intervention is becoming more and more feasible for the reactivation (inhibition of inhibition) of anticancer immune responses. This is the essence of immunotherapy. Here are some indications for current and emerging immunotherapeutic approaches to cancer treatment, such as modifying tumor microenvironment, the use of dendritic cells,, triggering tumor cell death by Oncothermia, the Immune checkpoint inhibitors etc.

Tumor microenvironment: Malignant tumors attract macrophages due to the hypoxia inside them and due to the necrotic areas they show. The presence of macrophages in the tumor is accompanied by a poor prognosis because they cause the production of anticoagulants (via the NF-κB factor), as well as inflammatory and tumor proliferative cytokines (IL-1, IL-6). They also promote neo-angiogenesis (with VEGF, TNF-α). These characters classify the macrophages of the tumor's microenvironment as M2-macrophages, which support the survival of cancer cells. One of the properties of oncothermia is that it converts M2 macrophages to M1, which show toxicity to cancer cells. This conversion is caused by the production of DAMPs (Damage Associated Molecular Patterns), according to the carcino-killing effect of oncothermia. This element, along with the induction of immunogenic cell death, also classifies oncothermia in immunotherapeutic methods.

Immune checkpoint inhibitors: The initial excitement has waned greatly, following the disappointing results of the use of the ipimumab inhibitor, which, in addition to causing 2% mortality, also triggered serious immune reactions in patients.