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New therapeutic avenues in colorectal cancer 

New therapeutic avenues in colorectal cancer
Chapter:
New therapeutic avenues in colorectal cancer
Author(s):

Christopher Ramsey

, Alan Anthoney

, and Harpreet Wasan

DOI:
10.1093/med/9780199590209.003.0012
Page of

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date: 22 September 2020

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.

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