[Immunological aspects of anticancer chemotherapy]

Bull Acad Natl Med. 2008 Oct;192(7):1469-87; discussion 1487-9.
[Article in French]

Abstract

For over 40 years, four therapeutic modalities, namely surgery, radiotherapy, chemotherapy and hormone therapy have formed the core of anticancer treatments. Their mode of action is thought to involve a direct cytotoxic action on tumor cells. Recently, the discovery of tumor-associated immunosuppression and tumor immunosurveillance has led to cancer being reconsidered not only as an organ disease but also as a host disease. This new concept is supported by the recent discovery of the immunogenic effects of tumor cell death induced by a variety of cytotoxic drugs. This work describes a new pathway of tumor-derived antigen presentation mediated by the alarmin HMGB1 (released by dying tumor cells in response to chemo/radiotherapy) and by TLR4 on dendritic cells. In this model, TLR4 recognizes? tumor-derived antigens, leading to T cell activation and to the induction of an antitumor immune response. Accordingly, we show that breast cancer patients bearing a loss-of-function mutation of the TLR4 receptor have shorter disease-free survival, confirming the major role of the immune system in the response to cytotoxic treatments. The response to chemotherapy and/or radiotherapy may thus combine both direct cytotoxic effects and the development of long-term antitumor immunity. We anticipate that these new results will have major impact on cancer management.

Publication types

  • English Abstract
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigen Presentation
  • Antigens, Neoplasm / immunology
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Apoptosis / drug effects
  • Apoptosis / immunology
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / genetics
  • Breast Neoplasms / immunology
  • Breast Neoplasms / mortality
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Cell Line, Tumor / drug effects
  • Cell Line, Tumor / immunology
  • Combined Modality Therapy
  • Dendritic Cells / immunology
  • Disease-Free Survival
  • HMGB1 Protein / genetics
  • HMGB1 Protein / physiology*
  • HeLa Cells / immunology
  • Humans
  • Immunologic Surveillance / drug effects
  • Melanoma / pathology
  • Models, Immunological*
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Polymorphism, Single Nucleotide
  • Radiotherapy / adverse effects
  • Recombinant Fusion Proteins / physiology
  • Retrospective Studies
  • Toll-Like Receptor 4 / genetics
  • Toll-Like Receptor 4 / physiology*

Substances

  • Antigens, Neoplasm
  • Antineoplastic Agents
  • HMGB1 Protein
  • Recombinant Fusion Proteins
  • TLR4 protein, human
  • Toll-Like Receptor 4