Immune checkpoint blockade in melanoma

Published on February 28, 2017   51 min

Other Talks in the Series: Immunotherapy of Cancer

0:00
Hello, my name is Elizabeth Buchbinder, and I'm a physician within the Melanoma Disease Center at Dana-Farber Cancer Institute, and an instructor at Harvard Medical School. And today, I'm going to be talking about Immune Checkpoint Blockade in Melanoma.
0:15
Immunotherapy has really been in the news a lot in the last few years, in terms of the amazing advances that have been seen in the treatment of cancer through the use of immunotherapy. However, some of the earliest efforts to use the immune system to battle against cancer, where in the early 1900s, when Dr. Coley, surgeon at the time, discovered that some of his patients who developed post-operative wound infections had subsequent responses in their tumors and shrinkage of their cancer. And he attempted to use this to elicit immune responses in patients by causing infections in their wound and their cancer. He had some success, however, in the end it was not something that caught on, given the fact that, many patients got very sick related to these infections. However, throughout time, there have been spontaneous regressions of cancer and some felt that a lot of these are related to the immune system's function and immune regulation of malignancy.
1:18
In addition to evidence that the immune system is causing regression in tumors, there is also evidence that the immune system can prevent the development of tumors, as can be observed in the fact that transplant patients who are on strong immunosuppressives have a much higher risk of developing malignancy as compared to the general population. And some of the tumors that are most commonly seen within these patients are those tumors that we now know have a very close relationship with the immune system and are tightly regulated by it such as kidney cancer and melanoma.
1:54
In addition to the observations, that the immune system seems to be potentially controlling some cancers and when suppressed can lead to the development of more cancers. There has been a lot of work recently looking within tumors to see if there are certain features of the immune system that may influence how those tumors grow. And it's been observed that immune cells within tumors can actually predict for patient's survival. In this study, patients with ovarian cancer were examined and it was seen that those patients with higher intratumoral T-cell volume, with more T-cells infiltrating into the tumor, had a much higher median overall survival than in those patients where those T-cells were restricted to the tissue surrounding the tumor, and no intratumoral T-cells were detected.
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Immune checkpoint blockade in melanoma

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