Cancer Genetics and Epigenetics 2024, Vol.12, No.1, 1-7 http://www.medscipublisher.com/index.php/cge 3 to immune dysregulation, such as immunodeficiency disorders and allergic conditions. Immune checkpoint inhibitors (such as anti CTLA-4 antibodies and anti PD-1 antibodies) are a commonly used class of immune modulators. Furthermore, immunomodulators are used to boost the effectiveness of vaccines, thereby enhancing vaccine protection. For example, adjuvants (such as aluminum salts) can augment the immunogenicity of vaccines. 2 Immunomodulator Application in Cancer Treatment 2.1 Mechanisms of immunomodulators in antitumor therapy The mechanisms through which immunomodulators act in anticancer treatment primarily involve enhancing immune responses, suppressing immune inhibition, and modulating immune balance. Immunomodulators can augment the body's immune system's ability to recognize and attack tumor cells. For instance, immunostimulants like interferons and interleukins can activate immune cells, increase the production and activation of tumor-specific T cells, and promote immune cell-mediated cytotoxicity against tumor cells. There are some immunosuppressive factors in the tumor microenvironment, such as the overexpression of immune checkpoint molecules (e.g., PD-1, CTLA-4), which inhibit the activation and cytotoxicity of immune cells against tumor cells (Huang et al., 2020). Immunomodulators can counteract the effects of immunosuppressive factors by inhibiting their actions, relieving the inhibition of immune cells, and enhancing the immune cells' ability to attack tumor cells. For example, anti-PD-1 antibodies and anti-CTLA-4 antibodies can block the PD-1 and CTLA-4 signaling pathways, restoring the activation and cytotoxic functions of immune cells. During the process of tumor development, the immune system often exists in a state of immune balance, wherein tumor cells evade immune system attacks by modulating the functions of immune cells. Immunomodulators can adjust this immune balance, enabling the immune system to regain its ability to target tumor cells. For example, immunosuppressants can inhibit the inhibitory functions of immune cells, enhancing the cytotoxic effects of immune cells against tumor cells. It should be noted that different types of tumors and individual immune states may have an impact on the anti-tumor effect of immune modulators. Therefore, when employing immunomodulators for anticancer treatment, personalized treatment plans should be formulated based on individual circumstances, and close monitoring of the patient's immune status and drug-related side effects is essential. 2.2 Application cases of immunomodulators in the treatment of different types of cancer The application of immunomodulators may vary across different types of cancer, and specific treatment plans need to be determined based on the patient's condition and immune status. Additionally, the use of immunomodulators may give rise to certain side effects, such as immune-related toxic reactions. Therefore, close monitoring of the patient's immune status and drug-related side effects is crucial throughout the course of treatment. PD-1 antibodies (such as Pembrolizumab and Nivolumab) have been widely employed in the treatment of melanoma (Huang et al., 2021). Melanoma patients often exhibit demonstrate of PD-1, and anti-PD-1 antibodies can block the binding of PD-1 to its ligand PD-L1, restoring T cell cytotoxicity against tumor cells, thereby enhancing therapeutic efficacy. CTLA-4 antibody (such as Ipilimumab) is used in the treatment of metastatic melanoma (Figure 1). CTLA-4 is an immune inhibitory molecule, and anti-CTLA-4 antibodies can block CTLA-4's function, enhancing T cell activation and cytotoxicity, thereby inhibiting the growth and spread of melanoma. Interferon is an immunostimulant widely utilized in the treatment of renal cell carcinoma. Interferon enhances the immune cell's ability to attack tumor cells and inhibits the growth and spread of tumor cells. Interleukin-2 (IL-2) is an immunostimulant used in the treatment of melanoma and renal cell carcinoma. IL-2 activates immune cells, increases the production and activation of tumor-specific T cells, and promotes the immune cell-mediated cytotoxicity against tumor cells.
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