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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery

Indexed/Abstracted in: EMBASE, Scopus




Otorinolaringologia 2004 June;54(2):71-80

language: English, Italian

Immunology and immunotherapy of head and neck carcinomas

Cortesina G., Martone T.

Second Division of Otorhinolaryngology Department of Clinical Physiopathology University of Turin, Turin, Italy


Tumor pro­gres­sion of ­head and ­neck car­ci­no­mas (HNC) is a mul­ti­phas­ic pro­cess evolv­ing ­through sev­er­al sequen­tial ­events, includ­ing ­gene alter­a­tions ­caused by virus­es or envi­ron­men­tal expo­sures and genet­ic pre­dis­po­si­tion. Although the ­host ­local ­immune ­system ­plays an impor­tant ­role in the initi­a­tion, pro­mo­tion and the ear­ly phas­es of neo­plas­tic pro­gres­sion, it ­does not ­appear to be suf­fi­cient to ­arrest the ­growth of ­these ­tumors. In ­fact, it is ­already ­well-known ­that ­patients ­with HNC ­have def­i­cits in ­immune func­tion. Several mech­a­nisms, ­linked ­both to the ­host and to the ­tumor, ­have ­been sug­gest­ed for the ­escape of malig­nant ­cells ­from ­host immu­no-sur­veil­lance. Tumors may down­reg­u­late the expres­sion of his­to­com­pat­ibil­ity anti­gens or ­they ­fail to ­express cos­ti­mol­a­to­ry mole­cules for the acti­va­tion of T-­cells. In addi­tion, ­they may ­release immu­no­sup­pres­sive mole­cules ­capable of par­a­lys­ing the effec­tor arm of the ­immune ­response. The com­pre­hen­sion of the molec­u­lar mech­a­nisms ­involved in immu­no­sup­pres­sion relat­ed to ­these ­tumors under­lies the increas­ing inter­est in find­ing new ther­a­peu­tic strat­e­gies. The ­goal of immu­no­ther­a­py strat­e­gies is essen­tial­ly to stim­u­late the spe­cif­ic ­immune ­response of the ­host, inter­rupt­ing the ­state of tol­er­ance ver­sus the anti­gens ­expressed by the ­tumor, via a varie­ty of ­reagents ­such as cyto­kines, infu­sion of T-­cell or vac­cines. Many of ­them are now in clin­i­cal ­trials. This ­review exam­ines the ­major strat­e­gies cur­rent­ly ­employed or ­under eval­u­a­tion for can­cer immu­no­ther­a­py and sum­mariz­es the ongo­ing pro­to­cols ­that are cur­rent­ly ­being eval­u­at­ed in clin­i­cal ­trials.

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