{"id":153,"date":"2024-11-15T11:01:13","date_gmt":"2024-11-15T16:01:13","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/chapter\/neoplasms-immune-response-and-immunotherapy\/"},"modified":"2024-11-15T11:01:13","modified_gmt":"2024-11-15T16:01:13","slug":"neoplasms-immune-response-and-immunotherapy","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/chapter\/neoplasms-immune-response-and-immunotherapy\/","title":{"raw":"Neoplasms - Immune Response and Immunotherapy","rendered":"Neoplasms &#8211; Immune Response and Immunotherapy"},"content":{"raw":"\n\n<h3><strong>Innate and Adaptive Immune Responses to Cancerous Cells<\/strong><\/h3>\nWithin the innate immune response, there are several leukocytes (i.e., White Blood Cells, WBCs) that play key roles in destroying cancerous cells.&nbsp; For example, powerful <strong>phagocytes <\/strong>(neutrophils, macrophages, and dendritic cells) as well as cytotoxic <strong>Natural Killer cells<\/strong> (NK cells) are able to recognized and kill many tumor cells.&nbsp; Additionally, the adaptive immune response, with various types of <strong>T cells<\/strong>, <strong>B cells<\/strong>, and <strong>antibodies<\/strong> also can play a role in recognizing tumor cells and targeting them for destruction.&nbsp; In order for a cancer to survive therefore it must evade the innate and adaptive immune systems.\n<h2><strong>Innate Immune Response to Cancerous Cells&nbsp;<\/strong><\/h2>\nThere are many components to the <strong>innate<\/strong> immune response, which include <strong>physical barriers<\/strong> (e.g., skin, hair, fingernails), <strong>chemicals<\/strong> (e.g., gastric acid, bile, normal flora), <strong>mechanical barriers<\/strong> (e.g., flushing of urine), phagocytic white blood cells (e.g., <strong>macrophages, monocytes, dendritic cells, neutrophils,<\/strong> and <strong>eosinophils),<\/strong> non-specific cytotoxic white blood cells (i.e., <strong>Natural Killer cells),<\/strong> certain <strong>plasma proteins<\/strong> (e.g., fibrinogen, complement proteins, and C-reactive proteins) and chemical messages (e.g., chemotactic <strong>chemokines,<\/strong> pro-inflammatory <strong>cytokines<\/strong> and <strong>pyrogens).<\/strong>\n<h4><em><strong>Innate Immune Response to Cancerous Cells - Phagocytes<\/strong><\/em><\/h4>\nPhagocytic white blood cells (WBCs or leukocytes) are capable of phagocytosing cell debris, as well as cells that display non-self (foreign) <strong>antigens.<\/strong>&nbsp; Most often these antigens belong to infectious agents or pathogens (e.g., bacteria, viruses), but sometimes these antigens are specific to tumor cells.&nbsp; <strong>Tumor-specific antigens<\/strong> (TSAs) are often coded by unmutated, abnormally spliced transcripts that are translated into unstable-short lived proteins that are unique to tumor cells.&nbsp; As these TSAs are non-self, non-specific phagocytes (e.g., macrophages, neutrophils, dendritic cells, and monocytes) are at times able to phagocytose tumor cells.&nbsp; Although this can be challenging as TSAs are unstable and present in low densities.&nbsp; It can also be difficult for phagocytes to penetrate and be activated within a tumor.\n<h4><em><strong>Innate Immune Response to Cancerous Cells - NK cells<\/strong><\/em><\/h4>\n<strong>Natural Killer Lymphocytes (NK cells)<\/strong> play an important role in the innate response, and are capable of killing both virally-infected and cancerous cells.&nbsp; This is achieved by their ability to check cells for self-antigens (Class I MHC Major Histocompatibility Complex molecules).&nbsp; Virally-infected cells typically display viral antigens on their cell surface <strong>Class I MHC molecules<\/strong> that stimulate NK cells.&nbsp; Cancerous cells on the other hand, can stimulate NK cells, because they are \"missing-self\" surface molecules, due to down-regulating the expression of the cell's Class I MHC surface molecules.&nbsp; Once active, NK cells release <strong>perforin<\/strong> proteins that create portals in the targeted virally-infected or cancerous cell.&nbsp; NK cells also release the enzyme <strong>granzyme<\/strong> which travels through the perforin portal into the target cell which induces apoptosis and cytolysis.&nbsp; At the same time, activated NK cells release <strong>pro-inflammatory cytokines<\/strong> which serve to recruit and activate other white blood cells (WBCs) such as CD8<sup>+<\/sup> Cytotoxic T cells, mast cells, basophils, macrophages and neutrophils. These cytokines also have <strong>potent anti-proliferative<\/strong>, <strong>anti-angiogenic<\/strong>, and <strong>pro-apoptotic<\/strong> effects on the cancerous cells.&nbsp; However, large solid tumors are often poorly oxygenated and difficult to penetrate - both the hypoxia and cellular density are challenge to NK cell abilities.&nbsp; &nbsp;Additionally, some tumors are able to suppress the anti-tumor effects of NK cells.&nbsp; Research is being done on strengthening the NK cell response to cancerous cells.\n\n&nbsp;\n<h2><strong>Adaptive Immune Response to Cancerous Cells<\/strong><\/h2>\n<h4>APC Activation of T cells, B cells, and Production of Anti-Tumor Antibodies<\/h4>\nThe adaptive immune system plays an important role in protecting against infectious agents (i.e. pathogens) as well as cancerous cells.&nbsp; Both T and B lymphocytes (T and B cells) are responsible for orchestrating a targeted attack of pathogenic and cancerous cells. Once activated Cytotoxic (CD8<sup>+<\/sup>) T cells produce daughter <strong>Cytotoxic T cells<\/strong>, that embark on a <strong>\"search and destroy\" mission<\/strong>, destroying cells that contain pathogenic or tumor-specific antigens.&nbsp; When <strong>B cells<\/strong> are activated, they proliferate to produce daughter cells that generate <strong>antibodies<\/strong> that will specifically bind to pathogenic or tumor-specific antigens, targeting them for phagocytosis by immune system phagocytes (e.g., neutrophils).\n\nIn order for T and B cells to become activated and launch a defense, non-self antigens (e.g., viral antigens, bacterial antigens or tumor-specific antigens) must be detected.&nbsp; In the case of pathogens, typically, <span style=\"text-decoration: underline\">A<\/span>ntigen-<span style=\"text-decoration: underline\">P<\/span>resenting <span style=\"text-decoration: underline\">C<\/span>ells, (i.e., APCs, which include macrophages and dendritic cells) are able to phagocytose pathogens and then display pathogen antigens on their cell surface using <strong>MHC Class II molecules<\/strong> in order to stimulate T and B cell activity and antibody production.&nbsp; APCs can also do this with tumor cells and <strong>tumor-specific antigens (TSAs),<\/strong> however, there are 2 challenges:\n\na) Most TSAs are unstable and short-lived, so most don't survive phagocytosis and then display by APCs.\n\nb) Tumor cells are often not surrounded by enough <strong>chemokines<\/strong> and <strong>cytokines<\/strong> that are required for attracting and activating APCs.\n\nMalignant tumor cells that evade the adaptive immune system can spread and metastasize.\n<h4>Direct Activation of Cytotoxic CD8<sup>+<\/sup> T cells by Tumor Cells<\/h4>\nIt is known that <strong>Cytotoxic T cells<\/strong> (CD8<sup>+<\/sup> cells) are capable of becoming active by directly interacting with foreign antigens (e.g., pathogens antigens or tumor-specific antigens, <strong>TSAs).<\/strong>&nbsp; However, T cell activation by tumor cells may be low or non-existent for a few reasons:\n\na) Most tumor cells often arise from epithelial cells, which express <strong>low levels of MHC Class I molecules<\/strong>, and therefore TSAs are displayed on the surface of cells at a low level.\n\nb) Most TSAs are <strong>unstable<\/strong> and <strong>short-lived<\/strong> which limits the ability for Cytotoxic T cells to bind them and be activated.\n\nResearch is being done on strengthening the APC, T and B cell responses to cancerous cells.\n\n&nbsp;\n<h3><strong>Malignant Neoplasms - Immunotherapy&nbsp; <\/strong><\/h3>\nThere are many strategies in place for harnessing the immune system and strengthening its response and ability to eliminate cancerous cells.&nbsp; Some of these strategies include using <strong>Biological Response Modifiers (BRMs)<\/strong>.&nbsp; BRMs are able to enhance or suppress the immune response.&nbsp; There are many types of BRMs that are useful in treating many different diseases (e.g., cancer, autoimmune diseases, chronic inflammatory diseases, and some cases of cardiovascular diseases).\n\n<strong>Biological Response Modifiers (BRMs)<\/strong> that are used to treat some cancers include:\n<ul>\n \t<li style=\"font-weight: 400\"><strong>Antibodies<\/strong> (produced in the lab) that bind to specifically to receptors that are present on some types of cancerous cells.&nbsp; Antibodies once bound to receptors on the surface of cancer cells act as opsonins and enable phagocytes (e.g., neutrophils and macrophages) to engulf and destroy the cancerous cell.&nbsp; Examples include:\n<ul>\n \t<li style=\"list-style-type: none\">\n<ul>\n \t<li>Antibodies against Human Epidermal Growth Factor Receptor 2 (HER-2) on some types of breast cancers.<\/li>\n \t<li>Antibodies against CD20, a cell membrane protein found on some types of B cell cancers (lymphomas).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n \t<li style=\"font-weight: 400\"><strong>Radioactive Antibodies:<\/strong> similar to the above example, monoclonal antibodies are produced in the lab and then attached to radioactive isotopes.&nbsp; The antibodies bind to the the specific tumor cell antigens, and the radioactive isotope degrades releasing damaging particles and energy that kills the cancerous cell.&nbsp; Both above examples can be radiolabelled, e.g.,\n<ul>\n \t<li>Radioactive Antibodies against Human Epidermal Growth Factor Receptor 2 (HER-2) on some types of breast cancers.<\/li>\n \t<li>Antibodies against CD20, a cell membrane protein found on some types of B cell cancers (lymphomas).<\/li>\n<\/ul>\n<\/li>\n \t<li><strong>Chemotherapy Drug conjugated Antibodies:<\/strong> monoclonal antibodies can also be attached to chemotherapy drugs.&nbsp; The antibodies bind to the specific tumor cell antigens, and the chemotherapy drug blocks cell cycling and\/or kills the cancerous cell.<\/li>\n<\/ul>\n&nbsp;\n<ul>\n \t<li><strong>Interferons:<\/strong>&nbsp; specific types of alpha interferons stimulate a greater immune response<\/li>\n \t<li><strong>Interleukin:<\/strong> specific types of interleukins are helpful in stimulating specific types of B cells (i.e., plasma cells) to produce more antibodies.<\/li>\n \t<li><strong>Granulocyte Macrophage Colony Stimulating Factors (GM-CSF)<\/strong> are growth factors that stimulate the production of granulocytes (e.g., neutrophils and basophils) and macrophages which boost the immune response<\/li>\n<\/ul>\n&nbsp;\n<ul>\n \t<li><strong>Vaccines to Prevent Cancer<\/strong>\n<ul>\n \t<li><strong>Human Papillomavirus (HPV) vaccine<\/strong> protects against HPV infections, as HPV oncoviruses are a risk factor for cancers of the cervix, penis, vagina, and oropharynx<\/li>\n \t<li><strong>Hepatitis B Virus (HBV) vaccine<\/strong> protects against the oncovirus HBV which is a risk factor for liver cancer<\/li>\n<\/ul>\n<\/li>\n \t<li><strong>Vaccines to Treat Cancer&nbsp;<\/strong>\n<ul>\n \t<li><strong>Bacillus Calmette- Guerin (BCG) vaccine<\/strong> was originally developed to prevent Tuberculosis.&nbsp; It is used to treat early-stage bladder cancer as it stimulates bladder inflammation and an immune response<\/li>\n<\/ul>\n<\/li>\n \t<li><strong>Vaccines being Researched for Treating Cancer<\/strong>\n<ul>\n \t<li><strong>Tumor whole cell vaccines<\/strong> - vaccines made from specific tumor cells<\/li>\n \t<li><strong>Tumor Antigen vaccines<\/strong> - vaccines made from tumor antigens<\/li>\n \t<li><strong>Dendritic Cell (DC) vaccines<\/strong> - made by harvesting DC cells and growing with cancer cells, priming DC cells to recognize tumor-specific antigens<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n&nbsp;\n<ul>\n \t<li><strong>Other Immunotherapies being Researched<\/strong>\n<ul>\n \t<li>Enhancing T cell immune response<\/li>\n \t<li>Enhancing Macrophage immune response<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n","rendered":"<h3><strong>Innate and Adaptive Immune Responses to Cancerous Cells<\/strong><\/h3>\n<p>Within the innate immune response, there are several leukocytes (i.e., White Blood Cells, WBCs) that play key roles in destroying cancerous cells.&nbsp; For example, powerful <strong>phagocytes <\/strong>(neutrophils, macrophages, and dendritic cells) as well as cytotoxic <strong>Natural Killer cells<\/strong> (NK cells) are able to recognized and kill many tumor cells.&nbsp; Additionally, the adaptive immune response, with various types of <strong>T cells<\/strong>, <strong>B cells<\/strong>, and <strong>antibodies<\/strong> also can play a role in recognizing tumor cells and targeting them for destruction.&nbsp; In order for a cancer to survive therefore it must evade the innate and adaptive immune systems.<\/p>\n<h2><strong>Innate Immune Response to Cancerous Cells&nbsp;<\/strong><\/h2>\n<p>There are many components to the <strong>innate<\/strong> immune response, which include <strong>physical barriers<\/strong> (e.g., skin, hair, fingernails), <strong>chemicals<\/strong> (e.g., gastric acid, bile, normal flora), <strong>mechanical barriers<\/strong> (e.g., flushing of urine), phagocytic white blood cells (e.g., <strong>macrophages, monocytes, dendritic cells, neutrophils,<\/strong> and <strong>eosinophils),<\/strong> non-specific cytotoxic white blood cells (i.e., <strong>Natural Killer cells),<\/strong> certain <strong>plasma proteins<\/strong> (e.g., fibrinogen, complement proteins, and C-reactive proteins) and chemical messages (e.g., chemotactic <strong>chemokines,<\/strong> pro-inflammatory <strong>cytokines<\/strong> and <strong>pyrogens).<\/strong><\/p>\n<h4><em><strong>Innate Immune Response to Cancerous Cells &#8211; Phagocytes<\/strong><\/em><\/h4>\n<p>Phagocytic white blood cells (WBCs or leukocytes) are capable of phagocytosing cell debris, as well as cells that display non-self (foreign) <strong>antigens.<\/strong>&nbsp; Most often these antigens belong to infectious agents or pathogens (e.g., bacteria, viruses), but sometimes these antigens are specific to tumor cells.&nbsp; <strong>Tumor-specific antigens<\/strong> (TSAs) are often coded by unmutated, abnormally spliced transcripts that are translated into unstable-short lived proteins that are unique to tumor cells.&nbsp; As these TSAs are non-self, non-specific phagocytes (e.g., macrophages, neutrophils, dendritic cells, and monocytes) are at times able to phagocytose tumor cells.&nbsp; Although this can be challenging as TSAs are unstable and present in low densities.&nbsp; It can also be difficult for phagocytes to penetrate and be activated within a tumor.<\/p>\n<h4><em><strong>Innate Immune Response to Cancerous Cells &#8211; NK cells<\/strong><\/em><\/h4>\n<p><strong>Natural Killer Lymphocytes (NK cells)<\/strong> play an important role in the innate response, and are capable of killing both virally-infected and cancerous cells.&nbsp; This is achieved by their ability to check cells for self-antigens (Class I MHC Major Histocompatibility Complex molecules).&nbsp; Virally-infected cells typically display viral antigens on their cell surface <strong>Class I MHC molecules<\/strong> that stimulate NK cells.&nbsp; Cancerous cells on the other hand, can stimulate NK cells, because they are &#8220;missing-self&#8221; surface molecules, due to down-regulating the expression of the cell&#8217;s Class I MHC surface molecules.&nbsp; Once active, NK cells release <strong>perforin<\/strong> proteins that create portals in the targeted virally-infected or cancerous cell.&nbsp; NK cells also release the enzyme <strong>granzyme<\/strong> which travels through the perforin portal into the target cell which induces apoptosis and cytolysis.&nbsp; At the same time, activated NK cells release <strong>pro-inflammatory cytokines<\/strong> which serve to recruit and activate other white blood cells (WBCs) such as CD8<sup>+<\/sup> Cytotoxic T cells, mast cells, basophils, macrophages and neutrophils. These cytokines also have <strong>potent anti-proliferative<\/strong>, <strong>anti-angiogenic<\/strong>, and <strong>pro-apoptotic<\/strong> effects on the cancerous cells.&nbsp; However, large solid tumors are often poorly oxygenated and difficult to penetrate &#8211; both the hypoxia and cellular density are challenge to NK cell abilities.&nbsp; &nbsp;Additionally, some tumors are able to suppress the anti-tumor effects of NK cells.&nbsp; Research is being done on strengthening the NK cell response to cancerous cells.<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>Adaptive Immune Response to Cancerous Cells<\/strong><\/h2>\n<h4>APC Activation of T cells, B cells, and Production of Anti-Tumor Antibodies<\/h4>\n<p>The adaptive immune system plays an important role in protecting against infectious agents (i.e. pathogens) as well as cancerous cells.&nbsp; Both T and B lymphocytes (T and B cells) are responsible for orchestrating a targeted attack of pathogenic and cancerous cells. Once activated Cytotoxic (CD8<sup>+<\/sup>) T cells produce daughter <strong>Cytotoxic T cells<\/strong>, that embark on a <strong>&#8220;search and destroy&#8221; mission<\/strong>, destroying cells that contain pathogenic or tumor-specific antigens.&nbsp; When <strong>B cells<\/strong> are activated, they proliferate to produce daughter cells that generate <strong>antibodies<\/strong> that will specifically bind to pathogenic or tumor-specific antigens, targeting them for phagocytosis by immune system phagocytes (e.g., neutrophils).<\/p>\n<p>In order for T and B cells to become activated and launch a defense, non-self antigens (e.g., viral antigens, bacterial antigens or tumor-specific antigens) must be detected.&nbsp; In the case of pathogens, typically, <span style=\"text-decoration: underline\">A<\/span>ntigen-<span style=\"text-decoration: underline\">P<\/span>resenting <span style=\"text-decoration: underline\">C<\/span>ells, (i.e., APCs, which include macrophages and dendritic cells) are able to phagocytose pathogens and then display pathogen antigens on their cell surface using <strong>MHC Class II molecules<\/strong> in order to stimulate T and B cell activity and antibody production.&nbsp; APCs can also do this with tumor cells and <strong>tumor-specific antigens (TSAs),<\/strong> however, there are 2 challenges:<\/p>\n<p>a) Most TSAs are unstable and short-lived, so most don&#8217;t survive phagocytosis and then display by APCs.<\/p>\n<p>b) Tumor cells are often not surrounded by enough <strong>chemokines<\/strong> and <strong>cytokines<\/strong> that are required for attracting and activating APCs.<\/p>\n<p>Malignant tumor cells that evade the adaptive immune system can spread and metastasize.<\/p>\n<h4>Direct Activation of Cytotoxic CD8<sup>+<\/sup> T cells by Tumor Cells<\/h4>\n<p>It is known that <strong>Cytotoxic T cells<\/strong> (CD8<sup>+<\/sup> cells) are capable of becoming active by directly interacting with foreign antigens (e.g., pathogens antigens or tumor-specific antigens, <strong>TSAs).<\/strong>&nbsp; However, T cell activation by tumor cells may be low or non-existent for a few reasons:<\/p>\n<p>a) Most tumor cells often arise from epithelial cells, which express <strong>low levels of MHC Class I molecules<\/strong>, and therefore TSAs are displayed on the surface of cells at a low level.<\/p>\n<p>b) Most TSAs are <strong>unstable<\/strong> and <strong>short-lived<\/strong> which limits the ability for Cytotoxic T cells to bind them and be activated.<\/p>\n<p>Research is being done on strengthening the APC, T and B cell responses to cancerous cells.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong>Malignant Neoplasms &#8211; Immunotherapy&nbsp; <\/strong><\/h3>\n<p>There are many strategies in place for harnessing the immune system and strengthening its response and ability to eliminate cancerous cells.&nbsp; Some of these strategies include using <strong>Biological Response Modifiers (BRMs)<\/strong>.&nbsp; BRMs are able to enhance or suppress the immune response.&nbsp; There are many types of BRMs that are useful in treating many different diseases (e.g., cancer, autoimmune diseases, chronic inflammatory diseases, and some cases of cardiovascular diseases).<\/p>\n<p><strong>Biological Response Modifiers (BRMs)<\/strong> that are used to treat some cancers include:<\/p>\n<ul>\n<li style=\"font-weight: 400\"><strong>Antibodies<\/strong> (produced in the lab) that bind to specifically to receptors that are present on some types of cancerous cells.&nbsp; Antibodies once bound to receptors on the surface of cancer cells act as opsonins and enable phagocytes (e.g., neutrophils and macrophages) to engulf and destroy the cancerous cell.&nbsp; Examples include:\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Antibodies against Human Epidermal Growth Factor Receptor 2 (HER-2) on some types of breast cancers.<\/li>\n<li>Antibodies against CD20, a cell membrane protein found on some types of B cell cancers (lymphomas).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><strong>Radioactive Antibodies:<\/strong> similar to the above example, monoclonal antibodies are produced in the lab and then attached to radioactive isotopes.&nbsp; The antibodies bind to the the specific tumor cell antigens, and the radioactive isotope degrades releasing damaging particles and energy that kills the cancerous cell.&nbsp; Both above examples can be radiolabelled, e.g.,\n<ul>\n<li>Radioactive Antibodies against Human Epidermal Growth Factor Receptor 2 (HER-2) on some types of breast cancers.<\/li>\n<li>Antibodies against CD20, a cell membrane protein found on some types of B cell cancers (lymphomas).<\/li>\n<\/ul>\n<\/li>\n<li><strong>Chemotherapy Drug conjugated Antibodies:<\/strong> monoclonal antibodies can also be attached to chemotherapy drugs.&nbsp; The antibodies bind to the specific tumor cell antigens, and the chemotherapy drug blocks cell cycling and\/or kills the cancerous cell.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Interferons:<\/strong>&nbsp; specific types of alpha interferons stimulate a greater immune response<\/li>\n<li><strong>Interleukin:<\/strong> specific types of interleukins are helpful in stimulating specific types of B cells (i.e., plasma cells) to produce more antibodies.<\/li>\n<li><strong>Granulocyte Macrophage Colony Stimulating Factors (GM-CSF)<\/strong> are growth factors that stimulate the production of granulocytes (e.g., neutrophils and basophils) and macrophages which boost the immune response<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Vaccines to Prevent Cancer<\/strong>\n<ul>\n<li><strong>Human Papillomavirus (HPV) vaccine<\/strong> protects against HPV infections, as HPV oncoviruses are a risk factor for cancers of the cervix, penis, vagina, and oropharynx<\/li>\n<li><strong>Hepatitis B Virus (HBV) vaccine<\/strong> protects against the oncovirus HBV which is a risk factor for liver cancer<\/li>\n<\/ul>\n<\/li>\n<li><strong>Vaccines to Treat Cancer&nbsp;<\/strong>\n<ul>\n<li><strong>Bacillus Calmette- Guerin (BCG) vaccine<\/strong> was originally developed to prevent Tuberculosis.&nbsp; It is used to treat early-stage bladder cancer as it stimulates bladder inflammation and an immune response<\/li>\n<\/ul>\n<\/li>\n<li><strong>Vaccines being Researched for Treating Cancer<\/strong>\n<ul>\n<li><strong>Tumor whole cell vaccines<\/strong> &#8211; vaccines made from specific tumor cells<\/li>\n<li><strong>Tumor Antigen vaccines<\/strong> &#8211; vaccines made from tumor antigens<\/li>\n<li><strong>Dendritic Cell (DC) vaccines<\/strong> &#8211; made by harvesting DC cells and growing with cancer cells, priming DC cells to recognize tumor-specific antigens<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Other Immunotherapies being Researched<\/strong>\n<ul>\n<li>Enhancing T cell immune response<\/li>\n<li>Enhancing Macrophage immune response<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n","protected":false},"author":1076,"menu_order":18,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon-zg0dnnskya"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[213],"license":[57],"class_list":["post-153","chapter","type-chapter","status-publish","hentry","contributor-zoe-soon-zg0dnnskya","license-cc-by-nc-sa"],"part":134,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/pressbooks\/v2\/chapters\/153","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/wp\/v2\/users\/1076"}],"version-history":[{"count":0,"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/pressbooks\/v2\/chapters\/153\/revisions"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/pressbooks\/v2\/parts\/134"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/pressbooks\/v2\/chapters\/153\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/wp\/v2\/media?parent=153"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/pressbooks\/v2\/chapter-type?post=153"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/wp\/v2\/contributor?post=153"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/zoesandbox\/wp-json\/wp\/v2\/license?post=153"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}