Recently, the authoritative academic journal Nature has published two articles from different teams, demonstrating the effect of a breakthrough new cancer therapy, the new tumor antigen vaccine. Two teams from the United States and Germany used different methods to create individualized vaccines for each patient, and preliminary trials in advanced melanoma patients achieved good results. These two studies have opened the door to true cancer individualized treatment options and are expected to have a profound impact on the field.

Cancer immunotherapy is a new idea for the treatment of cancer in recent years, and antibody drugs targeting the PD-1 and PD-L1 pathways are representative. The basic principle of cancer immunotherapy is to mobilize the patient's own immune system to attack cancer cells like an attacking bacteria. In theory, this therapy allows the immune system to recognize cancer cells, produce long-term anticancer effects, and has fewer side effects for patients than chemotherapeutic drugs.

However, cancer cells are very "squeaky" and use the mechanism of the body's immune system to escape the immune system. The PD-L1/PD-1 pathway is one of them. In general, PD-L1 is mainly expressed on immune cells and epidermal cells. When it binds to PD-1 receptor expressed on T cells, it can inhibit T cell proliferation and even cause T cell apoptosis, thereby protecting itself. Not being attacked. Many cancer cells take advantage of this and also express PD-L1 in large numbers, thus avoiding T cell attacks. PD-L1 and PD-1 antibody drugs block this signaling pathway and restore the ability of T cells to recognize cancer cells as invaders, thereby achieving anticancer effects.

PD-L1 and PD-1 antibody drugs work (Source: Smart Patients)

The PD-L1/PD-1 antibody drug represented by Bristol-Myers Squibb's nivolumab (Opdivo) and Merck Sharp & Dohme's pembrolizumab (Keytruda) is arguably the star of the current tumor field. drug. However, after blocking the PD-L1 and PD-1 signaling pathways, the immune system attacks both cancer cells and cells that normally express PD-L1, and thus still has considerable side effects.

Therefore, how to guide the immune system to selectively attack cancer cells has naturally become a new research focus. Some new immunotherapies, represented by CAR-T, can direct T cells to recognize cancer cells that express specific surface antigens, but these methods are currently only available for specific cancers.

CAR-T Cell Therapy (Source: Memorial Sloan Kettering Cancer Center)

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