ESMO E-Learning: Immunotherapy: Current/Emerging Methods, Resistance and Future Directions

In this E-Learning module, the author explores the immune system and mechanisms of action behind immune response to cancer, elaborates on current and emerging classes of immunotherapeutics available for the management of patients with cancer, and explains the strategies and research directions in the effort to overcome resistance to immunotherapy.

The author explains that the immune system is a key player in defeating cancer. It is designed to distinguish between the body’s own normal self and unhealthy cells or pathogens. Once they are recognised, the immune system communicates across the body and coordinates a response to eliminate the threats.

Immunotherapy is changing the landscape in oncology. Immunotherapeutics can offer long remissions/cures in subset of patients with cancer, while in others do not work or are linked to short-lasting responses. There are different immunotherapies with unique targets and potential for synergy with other therapies.

By explaining the patterns of response to immune checkpoint inhibitors, the author details the mechanisms of resistance to immunotherapy, including a range of tumour intrinsic factors, tumour local microenvironment and host-related factors.

Different immunotherapy-based combinations are already part of the routine clinical practice. The author also explains that opportunities to fight immunotherapy resistance come from non-overlapping mechanisms and targets that can result in better intensity and efficacy of antitumour immune responses.

In this E-Learning module, the author advocates for the development of novel, thoughtful clinical trials as the way to demonstrate the benefits of cancer immunotherapeutics and evolve as anticancer treatment.