Immunothérapie : les checkpoints

Immunotherapy may be the only approach to generating long-term protection against metastasis via the induction of adaptive immune responses with specific memories of multiple tumor antigens. Recent clinical evidence emphasize the importance of the immune response in controlling tumor progression. In localized tumor stage, infiltration by CD8+ T cell cytotoxic correlates with a good prognosis in solid tumors (carcinoma of the colon, breast, ovary, melanoma). Conversely, the infiltration suppressor cells such as regulatory T cells (Treg) or some macrophages is associated with poor prognosis. The cancer immunotherapy includes several complementary strategies : the transfer of immune cells, therapeutic vaccines, cytokines, vaccine adjuvants and monoclonal antibodies (mAbs). In particular, recent clinical success of mAb interfering with immune checkpoints (anti-CTLA-4, anti-PD-1 and PD-L1) in advanced cancers show that immunotherapy is a viable paradigm for the treatment of cancers. In addition, treatments combining immunotherapy and conventional treatments (chemotherapy, radiotherapy) should further improve this approach both in its effectiveness and in clinical indications.