Cancer immuno therapy

2.  The division of normal cells is precisely controlled. New
cells are only formed for growth or to replace dead ones.
 Cancerous cells divide repeatedly out of control even though
they are not needed, they crowd out other normal cells and
function abnormally. They can also destroy the correct
functioning of major organs.

3.  Cancer arises from the mutation of a normal gene.
 Mutated genes that cause cancer are called oncogene.
 It is thought that several mutations need to occur to give rise
to cancer
 Cells that are old or not functioning properly normally self
destruct and are replaced by new cells.
 Any agent that causes cancer is called a carcinogen and is
described as carcinogenic.
 So some mutagens are carcinogenic.

4. SARCOMAS
 Develop in the connective and supporting tissue e.g. muscle, cartilage, bones , fatty
tissues.
 Often very malignant increasing rapidly in size and invading neighboring tissues.
 Can develop in children. under 20 approximately.
MELANOMAS;
 Type of skin cancer often occurring on legs , neck , head.
 Often spread rapidly.
 It can develop from abnormal moles.
 Melanomas are usually brown or black, but can appear pink, tan, or even white.

5. Teratomas
 Arise from the embryonic cell that may be present in the
ovary , testicles and other areas.
Leukemias or Cancer of blood
 In this bone marrow produce too many white blood cells
that do not die off in this way that normal aging blood
cells do . instead they keep dividing and ultimately take
over healthy red blood cell, which our body depend on for
the normal oxygen and nutrient transport.

6. Carcinomas
 Develop from the epithelial cell , such as inside of the
cheek or lining of the intestine.
 Can occur in many regions of the body glands , ducts
,mucous membrane.
 (esophagus , colon , stomach , intestine)
Lymphomas
 cancers of the lymphatic system.

8.  Proto-oncogene; It is a normal gene which regulate
programmed cell death and give signal that lead to cell
division.
 Proto-oncogene is converted to oncogene (the gene that
has potential to cause cancer) by
• Mutation
• Chromosomal translocation

9.  Cancer cell continue to divide and accumulate form a
tumor
 Some cell from primary cancer break through and travel to
distant sites by mean of :
-invasion
-blood circulation
-Lymphatic system
 Cancer cell spread to other parts of body called metastasis.

11.  Both humoral and cell mediated immunity play a role against abnormal cell,viruses and bacteria.
 Humoral immunity
 B cell triggered when it encounters its matching antigens
 B cell engulf the antigen and digest it
 It display antigen fragments bound to its unique MHC molecules
 This combination of antigen and MHC attract the help of a mature matching T cell
 Cytokines secreted by the T cell help the B cell to multiply and mature into antibody producing Plasma
cell
 It went to blood and antibody lock onto matching antigen and antigen antibody complex are cleared by
complement cascade

12. The activation phase begins
when an antigen-presenting cell
of the host organism encounters
and attacks an invading virus.
. The processed antigens
combine with MHC class II
proteins and are presented on
the surface of the APC.
A helper T cell recognizes the
displayed antigen on the APC
and binds to the MHC class II
protein-antigen complex.
The activated helper T cell
releases chemical messengers
such as the cytokine IL-2 and
gamma interferon (IFN-g
Cytotoxic t cell recognized by
MHC I protein antigen complex
on the infected epithelial cell.
Cytokines also attract NK cells
to the site of infection.
The activated cytotoxic T cell
binds to the MHC class I protein
antigen complex on the surface
of the infected epithelial cell
which release a potent chemical
called Perforin which cause lysis
of cell

13.  The immune system recognizes and destroys tumor cells
that are constantly arising during the life of the individual
 IFN-gamma and lymphocytes prevent primary tumor
development and shape tumor immunogenicity

15.  One way is by recognizing stressed cells is stressed cell in
your body will show it on the cell surface. There are some
stress markers and that will be recognized by the immune
system and the immune system will simply kill the
stressed cells.
 the immune system is able to recognize mutations in self -
mutations that are required for normal cells to become a
cancer cell.

16. Tumor Antigen
Tumor specific
antigen
Tumor
associated
specific antigen

17.  Tumor Cells Frequently Express Low Levels of Class I
MHC Molecules.
 The decrease in class I MHC expression can be
accompanied by progressive tumor growth, and so the
absence of MHC molecules on a tumor is generally an
indication of a poor prognosis. The immune response itself
may play a role in selecting tumor cells with decreased
class I MHC expression

19.  Antitumor antibody itself acts as a blocking factor.
Presumably the antibody binds to tumor-specific antigens
and masks the antigens from cytotoxic T cells
 Immune complexes have been shown to block the CTL
response

20.  Without sufficient numbers of antigen-presenting
cells in the immediate vicinity of a tumor, the T
cells will receive only a partial activating signal

21.  Loss of Antigen Variant: Loss of Antigen Variant result
in that the T cell did not recognize Tumor.
 Production of immunosuppressive protein: result in
inhibition of T cell activation

24. » Treatment that uses certain parts of the immune system to fight
diseases such as cancer.
» Stimulating your own immune system to work harder or smarter to
attack cancer cells.
» In late 1800s, Dr William Coley treated cancer patients by
infecting them with certain kinds of bacteria, which came to be
known as Coley toxins.
» Giving you immune system components, such as man-made
immune system proteins.
» Immunotherapy is a type of cancer treatment which helps to boost
body’s natural defenses to fight the cancer, infection, and other
diseases or can be defined as the treatment of disease by stimulating
the body's production of antibodies; it is also known as biological
therapy.

25. Different forms of immunotherapy may be given in different ways.
These include:
 Intravenous: The immunotherapy goes directly into a vein.
 Oral: The immunotherapy comes in pills or capsules that you swallow.
 Topical: The immunotherapy comes in a cream that you rub onto your skin. This
type of immunotherapy can be used for very early skin cancer.
 Intravesical: The immunotherapy goes directly into the bladder.

26.  Non specific immunotherapies
 Immune checkpoint inhibitors
 Specific immunotherapy
 Tumor vaccines

27.  Also called biological response modifiers.
 Treatments to stimulate the immune system in a general way to increase
activity against cancer cells
 stimulate immune system in a general way but still can be good response
against cancer cells
 Some examples include man-made versions of cytokines, a chemical in
immune cells, such as interleukins and interferon’s.

28. » Injected either under skin, muscle or intravenous. cytokines are
divide into name of two chemicals named interleukins and
interferons
» Interleukins helps the cells to divide rapidly. they are made in laboratory
called interleukin-2, or aldesleukin.and used for treatment of kidney and
skin cancer. it can be combined with chemotherapy such as interferon-
Alfa. Other interleukins, such as IL-7, IL-12, and IL-21, are now being
studied for use against cancer.
» Interferons help to fight cancer and may help to slow the growth of
cancer cells. An interferon is made in laboratory, named as IFN-Alfa,
IFN-beta, and IFN-gamma

29.  Immune system depends on multiple check points or immunological
brakes to avoid over activation of the immune system on healthy cell.
 Tumor cells target molecules like PD-1, PD-L1, and CTLA-4. PD-1 is a
checkpoint protein on T cells. It normally acts as a type of “off switch”
that helps keep the T cells from attacking other cells in the body. It does
this when it attaches to PD-L1, a protein on some normal cells. When
PD-1 binds to PD-L1, it basically tells the T cell to leave the other cell
alone. Some cancer cells have large amounts of PD-L1, which helps them
evade immune attack
 These inhibitors target either PD-1 or PD-L1 can boost the immune
response against cancer cells and have shown a great deal of promise in
treating certain cancers.

30.  Thalidomide, lenalidomide, and pomalidomide, they are known as
immunomodulating drugs (or IMiDs). These drugs are used to
treat multiple myeloma and some other cancers.
 Certain bacteria's called Bacille Calmette-Guerin is a germ that
helps activate immune system. BCG was one of the earliest
immunotherapies used against cancer. BCG used to treat bladder
cancer and some melanoma skin cancers by injecting it directly into
the tumors
 One more drug named Imiquimod used as a cream on skin. It
stimulates immune response against skin cancer cells and is used to
treat some early stage skin cancers (or pre-cancers)

32.  The actual transfer of components of immune system which
are already capable of directing an immune response.
 Antibody therapy: MAB's constitute of pure population of
immune system proteins that attack specific molecular targets.
 When tipped with radioactive isotopes can home in on tumor
cells and deliver quick results.
 Work by activation of compliment system.
 To mark cells fir destruction.

33.  Cause an anti-proliferative effect by attaching to the
target tumor cells.
 Useful in causing apoptosis of the tumor cells too.
 Large population if MAB 's can be created in order to
specifically attain a target response against the tumor cells.

34.  Transfer of antigen specific T-cells
 After isolation from a cancer patient
 Expansion in test tube
 Re infusion back into patient
 Draw back : short life span

35.  Whole tumor cells extracted from patient.
 Blasted with radiations to weaken them.
 Adjuvants added to cause friendly environment within
patient for representation of antigen to immune system.