Page 10 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology Urgent focus on tumor immunotherapy

Immunotherapy has proven to be highly efficacious in patients. This high cost significantly impacts the broad
many cancer patients; however, the phenomenon of drug utilization of these medications, influencing patients’
resistance is widespread, with tumor cells often evading treatment options. Many patients lack access to these
immune cell attacks through various mechanisms. Both advanced treatments in regions with limited resources.
primary and adaptive resistance arise from a combination of The reduction of treatment costs, the enhancement of
intrinsic and extrinsic factors. Intrinsic factors include antigen accessibility for a broader patient population, and the
deletion, antigen presentation abnormality, genetic alterations improvement of immunotherapy accessibility are crucial
leading to T-cell rejection, or insensitivity to T-cells. Extrinsic issues that necessitate consideration.
factors encompass inhibitory immune cells, immune
checkpoint molecules, and immune-suppressing cytokines Immunotherapy has precipitated a paradigm shift
within the tumor microenvironment. Acquired resistance in managing tumors, yet numerous challenges persist.
can additionally manifest as the loss of T-cell function, Resolving these issues necessitates a multifaceted
downregulation of tumor antigen expression, mutations collaborative effort encompassing basic research, clinical
that hinder T-cell recognition, and escape mutations in practice, drug development, and policy support. We urge
tumor cells, amongst others. Developing effective strategies research institutions, pharmaceutical companies, and
3
to overcome drug resistance and prolong progression-free government agencies worldwide to collaborate to promote
survival in patients represents a significant research direction the advancement of immunotherapy, thereby extending
with considerable potential for future advances. hope to more patients.
In recent years, there has been a surge in research Conflict of interest
focusing on combining immunotherapy and other
therapeutic modalities, yielding promising. Integrating Xianbin Kong is an Editorial Board Member of this journal
nanomedicine, radiotherapy, and immunotherapy has but was not in any way involved in the editorial and peer-
shown positive outcomes, though it must be noted that review process conducted for this paper, directly or indirectly.
this approach has its challenges. These challenges include Separately, other authors declared that they have no known
the intricate physicochemical properties of nanoparticles, competing financial interests or personal relationships that
the complexity of assessing their distribution, metabolism, could have influenced the work reported in this paper.
and toxicity in vivo, and their susceptibility to clearance by
the reticuloendothelial system. Additional issues include References
reduced bioavailability of tumor sites, difficulties in tumor 1. Yildiz B, Acar R. Immunotherapy in geriatric patients with
targeting and penetration, nanoparticle toxicity, and advanced cancer. EJMO. 2020;4(3):209-214.
differences between pre-clinical models and patient tumors. doi: 10.14744/ejmo.2020.44446
Furthermore, challenges persist regarding the appropriate
timing of radiotherapy and immunotherapy, determining 2. Esfahani K, Meti N, Miller WH Jr., Hudson M. Adverse
optimal radiotherapy dosing, the direct effects of radiotherapy events associated with immune checkpoint inhibitor
on T-cells, and the identification of biomarkers for predicting treatment for cancer. CMAJ. 2019;191(2):E40-E46.
patient response to combination therapy. Addressing these doi: 10.1503/cmaj.180870
4,5
issues will require further basic and clinical research. 3. Sharma P, Hu-Lieskovan S, Wargo JA, Ribas A. Primary,
Biomarkers play a significant role in the immunotherapy adaptive, and acquired resistance to cancer immunotherapy.
of tumors, serving as crucial tools for treatment planning Cell. 2017;168(4):707-723.
and predicting treatment response and prognosis. However, doi: 10.1016/j.cell.2017.01.017
the currently available biomarkers (e.g., programmed
death-ligand 1 expression and tumor mutation load) 4. Wang Y, Deng W, Li N, et al. Combining immunotherapy
and radiotherapy for cancer treatment: Current challenges
have limitations that prevent them from fully meeting and future directions. Front Pharmacol. 2018;9:185.
clinical needs. Therefore, there is a clear need to develop
more definitive biomarkers to enhance the efficacy of doi: 10.3389/fphar.2018.00185
immunotherapy for patients with tumors. 5. Wang M, Yu F, Zhang Y. Present and future of cancer nano-
The elevated manufacturing expenses associated with immunotherapy: Opportunities, obstacles and challenges.
immunotherapy medications contribute to their high Mol Cancer. 2025;24(1):26.
cost, thereby imposing a substantial financial strain on doi: 10.1186/s12943-024-02214-5

Volume 9 Issue 2 (2025) 2 doi: 10.36922/EJMO025120059