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Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1

Ovarian cancer (OC) is the most lethal gynecologic malignancy, affecting approximately 1 in 70 women with only 45% surviving 5 years after diagnosis. This disease typically presents at an advanced stage, and optimal debulking with platinum-based chemotherapy remains the cornerstone of management. Al...

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Autores principales: Chardin, Laure, Leary, Alexandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710491/
https://www.ncbi.nlm.nih.gov/pubmed/34966689
http://dx.doi.org/10.3389/fonc.2021.795547
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author Chardin, Laure
Leary, Alexandra
author_facet Chardin, Laure
Leary, Alexandra
author_sort Chardin, Laure
collection PubMed
description Ovarian cancer (OC) is the most lethal gynecologic malignancy, affecting approximately 1 in 70 women with only 45% surviving 5 years after diagnosis. This disease typically presents at an advanced stage, and optimal debulking with platinum-based chemotherapy remains the cornerstone of management. Although most ovarian cancer patients will respond effectively to current management, 70% of them will eventually develop recurrence and novel therapeutic strategies are needed. There is a rationale for immune-oncological treatments (IO) in the managements of patients with OC. Many OC tumors demonstrate tumor infiltrating lymphocytes (TILs) and the degree of TIL infiltration is strongly and reproducibly correlated with survival. Unfortunately, results to date have been disappointing in relapsed OC. Trials have reported very modest single activity with various antibodies targeting PD-1 or PD-L1 resulting in response rate ranging from 4% to 15%. This may be due to the highly immunosuppressive TME of the disease, a low tumor mutational burden and low PD-L1 expression. There is an urgent need to improve our understanding of the immune microenvironment in OC in order to develop effective therapies. This review will discuss immune subpopulations in OC microenvironment, current immunotherapy modalities targeting these immune subsets and data from clinical trials testing IO treatments in OC and its combination with other therapeutic agents.
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spelling pubmed-87104912021-12-28 Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1 Chardin, Laure Leary, Alexandra Front Oncol Oncology Ovarian cancer (OC) is the most lethal gynecologic malignancy, affecting approximately 1 in 70 women with only 45% surviving 5 years after diagnosis. This disease typically presents at an advanced stage, and optimal debulking with platinum-based chemotherapy remains the cornerstone of management. Although most ovarian cancer patients will respond effectively to current management, 70% of them will eventually develop recurrence and novel therapeutic strategies are needed. There is a rationale for immune-oncological treatments (IO) in the managements of patients with OC. Many OC tumors demonstrate tumor infiltrating lymphocytes (TILs) and the degree of TIL infiltration is strongly and reproducibly correlated with survival. Unfortunately, results to date have been disappointing in relapsed OC. Trials have reported very modest single activity with various antibodies targeting PD-1 or PD-L1 resulting in response rate ranging from 4% to 15%. This may be due to the highly immunosuppressive TME of the disease, a low tumor mutational burden and low PD-L1 expression. There is an urgent need to improve our understanding of the immune microenvironment in OC in order to develop effective therapies. This review will discuss immune subpopulations in OC microenvironment, current immunotherapy modalities targeting these immune subsets and data from clinical trials testing IO treatments in OC and its combination with other therapeutic agents. Frontiers Media S.A. 2021-12-13 /pmc/articles/PMC8710491/ /pubmed/34966689 http://dx.doi.org/10.3389/fonc.2021.795547 Text en Copyright © 2021 Chardin and Leary https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Chardin, Laure
Leary, Alexandra
Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1
title Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1
title_full Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1
title_fullStr Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1
title_full_unstemmed Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1
title_short Immunotherapy in Ovarian Cancer: Thinking Beyond PD-1/PD-L1
title_sort immunotherapy in ovarian cancer: thinking beyond pd-1/pd-l1
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710491/
https://www.ncbi.nlm.nih.gov/pubmed/34966689
http://dx.doi.org/10.3389/fonc.2021.795547
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