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Immune Therapy for Sarcomas

  • Chapter
  • First Online:
Immunotherapy

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 995))

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Abstract

Absolute lymphocyte count (ALC) recovery rapidly occurring at 14 days after start of chemotherapy for osteosarcoma and Ewing sarcoma is a good prognostic factor. Conversely, lymphopenia is associated with significantly decreased sarcoma survival. Clearly, the immune system can contribute towards better survival from sarcoma. This chapter will describe treatment and host factors that influence immune function and how effective local control and systemic interventions of sarcoma therapy can cause inflammation and/or immune suppression but are currently the standard of care. Preclinical and clinical efforts to enhance immune function against sarcoma will be reviewed. Interventions to enhance immune function against sarcoma have included regional therapy (surgery, cryoablation, radiofrequency ablation, electroporation, and radiotherapy), cytokines, macrophage activators (mifamurtide), vaccines, natural killer (NK) cells, T cell receptor (TCR) and chimeric antigen receptor (CAR) T cells, and efforts to decrease inflammation. The latter is particularly important because of new knowledge about factors influencing expression of checkpoint inhibitory molecules, PD1 and CTLA-4, in the tumor microenvironment. Since these molecules can now be blocked using anti-PD1 and anti-CTLA-4 antibodies, how to translate this knowledge into more effective immune therapies in the future as well as how to augment effectiveness of current interventions (e.g., radiotherapy) is a challenge. Barriers to implementing this knowledge include cost of agents that release immune checkpoint blockade and coordination of cost-effective outpatient sarcoma treatment. Information on how to research clinical trial eligibility criteria and how to access current immune therapy trials against sarcoma are shared, too.

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Acknowledgements

The author acknowledges Drs. Tom Budd, Dale Shepard, and Charis Eng for helpful discussions at our Cleveland Clinic Sarcoma seminars.

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  1. Department of Pediatric Hematology/Oncology/BMT, Cleveland Clinic S20, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Peter M. Anderson M.D., Ph.D.

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  1. Peter M. Anderson M.D., Ph.D.
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Correspondence to Peter M. Anderson M.D., Ph.D. .

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Editors and Affiliations

  1. MD Anderson Cancer Center, University of Texas, Houston, Texas, USA

    Aung Naing

  2. Baylor College of Medicine-Texas Children’s Hospital, Houston, Texas, USA

    Joud Hajjar

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Anderson, P.M. (2017). Immune Therapy for Sarcomas. In: Naing, A., Hajjar, J. (eds) Immunotherapy. Advances in Experimental Medicine and Biology, vol 995. Springer, Cham. https://doi.org/10.1007/978-3-319-53156-4_6

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