The immune modifying effects of chemotherapy and advances in chemo-immunotherapy

Immune checkpoint inhibitors (ICIs) have transformed the treatment paradigm for several malignancies. While the use of single-agent or combined ICIs has achieved acceptable disease control rates ina variety of solid tumors, such approaches have yet to show substantial therapeutic efficacy in select difficult-to-treat cancer types. Re-cently, select chemotherapy regimens are emerging as extensive modifiers of the tumor microenvironment, lead-ing to the reprogramming of local immune responses. Accordingly, data is now emerging to suggest that certain anti-neoplastic agents modulate various immune cell processes, most notably the cross-presentation of tumor antigens, leukocyte trafficking, and cytokine biosynthesis. As such, the combination of ICIs and cytotoxic chemo-therapy are beginning to show promise in many cancers that have long been considered poorly responsive to ICI-based immunotherapy. Here, we discuss past and present attempts to advance chemo-immunotherapy in these difficult-to-treat cancer histologies, mechanisms through which select chemotherapies modify tumor immuno-genicity, as well as important considerations when designing such approaches to maximize efficacy and improve therapeutic response rates. (c) 2022 Elsevier Inc. All rights reserved.

Automated summary

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of several malignancies but have limited efficacy in certain difficult-to-treat cancer types. Recent research suggests that specific chemotherapy regimens can modify the tumor microenvironment, leading to changes in immune responses. Therefore, the combination of ICIs and cytotoxic chemotherapy shows promise in treating previously unresponsive cancers.