The hallmarks of successful anticancer immunotherapy

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Science Translational Medicine  19 Sep 2018:
Vol. 10, Issue 459, eaat7807
DOI: 10.1126/scitranslmed.aat7807

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  • RE: Understanding the Hallmarks of successful anticancer immunotherapy: is Pharmacokinetics the hidden biomarker?
    • Joseph Ciccolini, Hospital Pharmacist, Aix Marseille University
    • Other Contributors:
      • Vesna Cuplov, Pharmacometrician, Aix Marseille Univ
      • Bruno Lacarelle, Hospital Pharmacist, Aix Marseille University
      • Dominique Barbolosi, Pharmacometrician, Aix Marseille Univ
      • Fabrice Barlesi, Oncologist, Aix Marseille University

    Although considered as a groundbreaking innovation in oncology, successful immunotherapy is restrained today to a limited number of patients in an even more limited number of solid tumors. In the September 2018 issue of Science Translational Medicine, Galluzzi and colleagues proposed a thorough review aiming at defining the hallmarks of successful anticancer immunotherapy (1). In particular, the authors highlighted the pitfalls related to the heterogeneity of most solid tumors, the constant and utterly complex interplays between stroma, endothelium and immune infiltrate, as well as tumor evolutionary and disrupted gut microbiote issues. All are likely to impair the efficacy of immunotherapy and blur the picture when trying to predict efficacy. As a consequence, no biomarker with robust predictive value has been clearly validated yet to forecast clinical outcome in patients undergoing immunotherapy. This could be a serious issue because of the ever-increasing cost of immune checkpoint inhibitors, especially since developing strategies to improve efficacy remains a challenging task. Unfortunately, in their review Galluzzi et al. have chosen not to take into account largely unaddressed issues related to possible inadequate drug exposure levels, as a putative cause explaining the lack of efficacy with immune checkpoint inhibitors. One of the common characteristic of all the clinical studies they have cited with immunotherapy is the complete lack of knowledge of circulating d...

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    Competing Interests: None declared.

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