Cancer Immune Therapy Edited by G. Stuhler and P. Walden ...

216 10 The Immune System in Cancer: If It Isn't Broken, Can We Fix It?
Fig. 10.5 How the immune system could be
manipulated for effective antitumor immunotherapy.
(A) What the immune system should
not do: In autoimmune disease, it is believed
that some initiating factor, e. g. viral or bacterial
infection, serves as an adjuvant to initiate cell
death of the target tissue. Antigen release occurs
in the context of full immune activation. Molecular
mimicry of a self antigen by a pathogenic
antigen or direct activation of a potentially selfreactive
T cell leads to activation of an autoimmune
response from a small repertoire of such
T cells. (B) What we would like the immune sys-
tem to do. Effective immunotherapy strategies
for cancer will combine elements from Figs
10.4(A) and 10.5(A) (e. g. identification of foreign
pathogens or autoimmune initiating agents
along with gene transfer) to stimulate tumor cell
killing and promote the creation of a highly immunostimulatory
environment associated with
release of tumor antigens. Although the antigens
released will be predominantly self or near-self,
they will be presented in a stimulatory fashion to
a small pool of potentially reactive T cells that
might have the ability to initiate and maintain
antitumor immune responses.