L'immunite antitumorale: de concepts a l'immunotherapie active specifique

The field of immunotherapy moved forward with the recent advances in the cell biology of antigen presentation and molecular approaches to tumor antigen characterization. Whereas tumor cells were believed to be poor immunogens, a variety of tumour antigens have been recently characterize that are mostly self-Ag and the question comes: how to overcome self tolerance in cancer bearing patients? Single or string beads CTL defined epitope-based strategies proved useful for immunization in a variety of mouse tumor models and in human melanoma, along with adjuvants such as cytokines or dendritic cells. While the ultimate aim of immunotherapy is to induce lytic effector cells, optimal approaches should not only promote CTL priming but also potent auxiliary response. Recombinant tumor cells or dendritic cells and their exosomes as well as engineered viruses have been demonstrated to elicit specific antitumor immune responses leading to tumor growth suppression and long lasting immunity. Flt3L is an in vivo DC growth factor that offers novel options in the field of immunization. These immunotherapeutic approaches are being tested in clinical trials, evaluated with novel tools of immunomonitoring and open up novel avenues for disease free patients with poor prognosis factors. Innate immunity might modulate cognate immune responses allowing significant clinical regressions.