By. Bridget Keenan, MD
Date. 11/22/2023
Bridget Keenan, MD, discusses the tumor microenvironment (TME) and its crucial role in cancer immunotherapy responses. Dr. Keenan notes that effector T cells align with positive outcomes, while suppressive myeloid cells and cytokine signals within the TME often signify a less favorable prognosis and resistance to immunotherapy.
During the presentation, Dr. Keenan explores targeting the TME through immunotherapies, focusing on tumor metabolism and immunosuppressive myeloid cells. Despite various drugs aiming at the TME, no standout winner has emerged, prompting Dr. Keenan to discuss potential strategies for more effective interventions.
She highlights exploring metabolic byproducts with higher concentrations in the TME, using adenosine inhibitors as an example due to their inhibitory effects on the immune system. Myeloid cells, displaying diverse phenotypes, offer another target, either through inhibition or repolarization.
Dr. Keenan underscores the importance of personalized immunotherapy strategies based on the TME components. She envisions a future where immune profiling of tumors before therapy becomes routine, enabling the identification of critical elements in the TME that require targeting for a successful response.
Liver metastases, identified as a significant hurdle in immunotherapy response, are discussed in the context of their tolerogenic nature. Dr. Keenan acknowledges the challenges posed by liver metastases and the ongoing efforts to understand and overcome them, particularly focusing on T regulatory cells as potential drivers.
The presentation concludes with Dr. Keenan exploring adenosine inhibition as an anti-cancer therapy, noting modest response rates. She envisions the future development of adenosine-targeted therapies, emphasizing the importance of personalized approaches based on cancer types with high expression of relevant molecules. Additionally, she suggests combining adenosine inhibitors with other immunotherapies to enhance treatment efficacy.