Evolution of Cancer, Adaptive Immunity, and Immunotherapy

The first clinical trials to investigate the efficacy of immunotherapy in cancer were problematic because of issues related to product availability, cost, and purity. Moreover, these factors could have contributed to the modest efficacy of these agents. The ability to clone specific genes coupled with the development of recombinant DNA technology removed some major barriers such that only 20 years later, approval of the first engineered monoclonal antibody (mAb) for clinical use occurred with practice-changing implications. Subsequent to rituximab, more than 30 additional mAbs have indications for a number of hematologic malignancies and solid tumors. Indeed, the application of adaptive immunity is now an integral component of therapy for many cancers. This paper delves into the complex science of immunology by investigating how the term evolution is applicable to tumorigenesis, the adaptive immune response, and cancer therapy.