Barriers to Immunotherapy in Ovarian Cancer: Metabolic, Genomic, and Immune Perturbations in the Tumour Microenvironment.
Racheal Louise JohnsonMichele CummingsAmudha ThangaveluGeorgios TheophilouDiederick de JongNicolas Michel OrsiPublished in: Cancers (2021)
A lack of explicit early clinical signs and effective screening measures mean that ovarian cancer (OC) often presents as advanced, incurable disease. While conventional treatment combines maximal cytoreductive surgery and platinum-based chemotherapy, patients frequently develop chemoresistance and disease recurrence. The clinical application of immune checkpoint blockade (ICB) aims to restore anti-cancer T-cell function in the tumour microenvironment (TME). Disappointingly, even though tumour infiltrating lymphocytes are associated with superior survival in OC, ICB has offered limited therapeutic benefits. Herein, we discuss specific TME features that prevent ICB from reaching its full potential, focussing in particular on the challenges created by immune, genomic and metabolic alterations. We explore both recent and current therapeutic strategies aiming to overcome these hurdles, including the synergistic effect of combination treatments with immune-based strategies and review the status quo of current clinical trials aiming to maximise the success of immunotherapy in OC.
Keyphrases
- clinical trial
- end stage renal disease
- stem cells
- ejection fraction
- minimally invasive
- newly diagnosed
- copy number
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- coronary artery bypass
- randomized controlled trial
- gene expression
- risk assessment
- blood pressure
- combination therapy
- cancer therapy
- drug delivery
- chemotherapy induced