Cancer immunology is an exciting and expanding area of research. The convergence of new technology and leading scientific minds has brought us to a point where we are able to alter the course of cancer in ways we could only imagine a few decades ago.
Immune cells in the blood primarily defend us against infection. But we’re now learning that these cells can keep us free from cancer. Patients with less efficient immune systems, such as people who have had organ transplants or those with untreated HIV, are more susceptible to cancers. It’s also apparent that we can use immune cells to predict survival in people who develop cancer. And that, in fact, that there are immune cells within cancers.
The number of immune cells inside a tumour can vary hugely: some people have vast numbers while others have very few. In a recent study,1 our researchers showed that, in head and neck cancers, the survival of a patient depends on how many immune cells are present in a tumour. This could be a valuable way of individualising cancer treatments. Patients with lots of immune cells could possibly be offered less toxic cancer treatment than those with few immune cells.
Not all immune cells in a tumour are able to attack the cancer. By looking at specific cell markers – proteins on the cell exterior that allow us to see whether cells are exhausted – we can determine which individual immune cells will be effective in tackling the cancer. We may even be able to reinvigorate exhausted cells through targeted immunotherapy treatments, including vaccines. So, if a cancer has been caused by a virus, we can vaccinate the patient with a short segment of the same virus to encourage the immune system to react to it.
For people who don’t have many immune cells in their tumours, targeted immunotherapy could be an option. Broader ‘brushstroke’ treatments, which encourage a patient’s immune system in a non-specific way, might also be appropriate. Our immune cells are normally very tightly regulated so they don’t overreact to infections. General immunotherapy takes the brakes off and allows the immune cells to react to the cancer cells.
It may be that a combination of specific vaccine and non-specific immune treatments could be used to tip the balance in favour of the patient’s immune system so that it is able to overcome the cancer.
In future, rather than relying on toxic drugs and radiation to kill cancer cells, we will treat most cancers by mobilising the body’s natural defences. And, exciting early results suggest that when the immune system is harnessed effectively, it not only eradicates malignant disease but also provides lasting protection.
Read more about beating blood cancers in the latest edition of New Boundaries
The University of Southampton is the UK’s leading centre for cancer immunology and is recognised nationally and internationally for translating laboratory research through clinical trials to new treatments for patients. Our new Centre will help us explore the huge potential of immunology further and bring us closer to a cure for all forms of cancer.
1 Ward MJ, Thirdborough SM, Mellows T, Riley C, Harris S, Suchak K, Webb A, Hampton C, Patel NN, Randall CJ, Cox H, Jogai S, Primrose J, Piper K, Ottensmeier CH, King EV, Thomas GJ (2014). ‘Tumour-infiltrating lymphocytes predict for outcome in HPV-positive oropharyngeal cancer’.
British Journal of Cancer, 110(2): 489-500, 21 Jan, doi: 10.1038/bjc.2013.639. Epub 2013 Oct 29.