Chemoimmunotherapy

Chemoimmunotherapy is chemotherapy combined with immunotherapy. Chemotherapy uses different drugs to kill or slow the growth of cancer cells; immunotherapy uses treatments to stimulate or restore the ability of the immune system to fight cancer. A common chemoimmunotherapy regimen is CHOP combined with rituximab (CHOP-R) for B-cell non-Hodgkin lymphomas.

External links

• NCI Dictionary of Cancer Terms - Definition of chemoimmunotherapy

Introduction

Cancer therapy has evolved to strategically integrate distinct treatment modalities in order to optimize the chance of cure. Surgery and radiation therapy are used to achieve locoregional control, whereas systemic therapies (chemotherapy, endocrine therapy, molecularly targeted therapies, and adjunctive therapies (bisphosphonates)) are used to control diffuse disease (in hematologic malignancies) or disease that has spread beyond the primary site (in solid tumors).^[1] Combination of different therapies in cancer has become a trend, not just between different types of therapies, also multiple drugs with complementary mechanisms. And these combinations do have a better effect on five-year survival rate and delaying tumor relapse.

Chemotherapy

In the early 1900s, the famous German chemist Paul Ehrlich set about developing drugs to treat infectious diseases. He was the one who coined the term "chemotherapy" and defined it as the use of chemicals to treat disease, he was also the first person to document the effectiveness of animal models to screen a series of chemicals for their potential activity against diseases, an accomplishment that had major ramifications for cancer drug development. During world war II, a national drug development program appeared as Cancer Chemotherapy National Service Center.^[2] And good examples in curing acute childhood leukemia and advanced Hodgkin's disease encouraged people to screen more chemicals that have anti-tumor activities. Provided a diversity of anti-tumor chemicals, people started to use cocktail of different drugs and surprisingly found it would have a better outcome. At beginning, people didn't even think about cancer cell could be killed by chemicals, let alone cancer-specific therapies.

Immunotherapy

As for immunotherapy, it early mentioned by

There are several good examples. The standard treatment for patients with diffuse large-B-cell lymphoma is cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Rituximab, a chimeric monoclonal antibody against the CD20 B-cell antigen, has therapeutic activity in diffuse large-B-cell lymphoma5. People proved that the addition of rituximab to the CHOP regimen increases the complete-response rate and prolongs event-free and overall survival in elderly patients with diffuse large-B-cell lymphoma, without a clinically significant increase in toxicity.^[5] For metastatic breast cancer that overexpresses HER2, chemoimmunotherapy also has a better effect. HER2 gene, encodes the growth factor receptor HER2, is overexpressed in 25 to 30 percent of breast cancers, increasing the aggressiveness of the tumor. Trastuzumab is a recombinant monoclonal antibody against HER2, clinical trials showed that the addition of trastuzumab to chemotherapy was associated with a longer time to disease progression, a higher rate of objective response, a longer duration of response, a lower rate of death at 1 year, longer survival, and a 20 percent reduction in the risk of death, which proves trastuzumab increases the clinical benefit of first-line chemotherapy in metastatic breast cancer that overexpresses HER2.^[6]

References