from basic to tumor immunology for oncologist · from the essentials of tumor immunology to...
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From basic to tumorimmunology for oncologist
ESMO Preceptorship Program: Immuno -Oncology,From the essentials of tumor immunology
to clinical application – May 4 2018, Lugano
Pedro RomeroLudwig Cancer Research Center,
Department of Fundamental Oncology,FBM,University of Lausanne
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It all started ca. 1895 – NY Hospital
Immuno -Oncology is ~ 120 years old
ORR by 1900 – 20%, tumor type: sarcomas
ORR by 2018 – close to 100% in HM,20 – 50% in solid tumors
Products – toxins by 1900; CAR T cells andmAbs by 2018
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Major Questions
Can the Immune System recognize Cancer?
Can we use the Immune System tofight Cancer?
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« It ’s every immunologist ’s dream to use the immune system to cure cancer. It ’s every immunologist’s nightmare that there is not such a thing as an immune response to cancer in humans. »
Steven Rosenberg, 1992
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Concept of immunosurveillance
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0 10 20 30 100 200 300 400 500 600 700
Days
Tum
or v
olum
e ~ 20 %
Low dosecarcinogen
α-CD4, α-CD8α-IFN-γ
Adaptive immunity can confer long term and effectiv econtrol of minimal tumor burden
RD Schreiber, M Smyth & LJ Old
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The current model ofimmunoediting: the three Es
Elimination
Equilibrium
Escape
• Effective antigen processing/presentation
• Effective activation and function of effector cells‒ e.g. T cell activation
without co-inhibitory signals
• Tumours avoid elimination through the outgrowth of tumour cells that can suppress, disrupt, or ‘escape’ the immune system
• Genetic instability• Tumour heterogeneity• Immune selection
Cancer immunosurveillance
Cancer dormancy
Cancer progression
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Recognition of tumors bythe immune system
What are the tumor targets recognized by T and
B cells?
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Structure of physiological antigen receptors
M. Sadelain et al. Nat Rev Cancer 2003
T CELL RECEPTOR (TCR)B CELL RECEPTOR (BCR)
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T Cell Receptor Antibody
Membrane Membrane and soluble
Two chains Two H and L chains
CDR1, 2 and 3 CDR1, 2 and 3
Ligand: MHC/peptidealso unrestricted
unrestricted
Two isotypes: αβ, γδFive classes: M, G, A, D, ESeveral isotpyes, per class
Low affinity (10 -5 M)No affinity maturation
High affinity (10 -9 – 10-11)Affinity maturation
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CYTOLYTIC CD8 + T LYMPHOCYTES(CTL),
the major effectorsof anti-tumoradaptive immunity
- Direct lysis (perforin, GZB)- IFN-γ, TNF-α, GM-CSF …- Fas L- CD40L