Chapter

New therapeutic avenues in colorectal cancer

Christopher Ramsey, Alan Anthoney and Harpreet Wasan

in Colorectal Cancer

Published on behalf of Oxford University Press

ISBN: 9780199590209
Published online May 2012 | e-ISBN: 9780191739675 | DOI: http://dx.doi.org/10.1093/med/9780199590209.003.0012

Series: Oxford Oncology Library

New therapeutic avenues in colorectal cancer

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• Current research in immunotherapy centres on provoking either a cytotoxic T-cell response or production of tumour specific antibodies • Relative success has been achieved with whole tumour cell vaccines. Use of single or multi-tumour derived peptides may be more efficient and cost effective. The results of the 1st randomized trials are awaited • Trials in colorectal cancer are awaited for • Autologous dendritic cell vaccines primed with whole tumour cell lysates or tumour derived peptides • Anti-heat shock proteins (HSP) vaccines; HSP are chaperone proteins that present tumour associated antigens (TAA) to antigen presenting cell (APC)s via specific anti-HSP receptors • DNA based vaccines able to deliver low immunogenic TAAs bound to highly immunogenic foreign DNA • Virus vector vaccines that deliver recombinant genes that may express TAAs, co-stimulatory proteins or cytokines that can produce an heightened immune response • The liver is the most frequent site of colorectal metastatic disease and organ specific events lead to global loss of quality and quantity of life. Hence organ directed therapy is a rational approach • Randomized studies have provided evidence of a survival benefit for one such method, Hepatic arterial (HA) chemotherapy although this has not been broadly adopted • Radioembolization consists of administration via the HA of particles loaded with Yittrium 90. Two large scale randomized studies in the first line treatment of liver predominant disease are currently running following provocative data from studies in first, second and third line settings.

Chapter.  5441 words. 

Subjects: Medical Oncology

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