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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.