The immune system and gastrointestinal stromal tumor: a wealth of opportunities. Issue 4 (July 2015)

• Record Type: Journal Article
• Authors: Tan, Yaohong; Garcia-Buitrago, Monica T.; Trent, Jonathan C.; Rosenberg, Andrew E.
• Is Part Of: Current opinion in oncology. Volume 27:Issue 4(2015:Jul.)
• Publication Date: 2015-07
• Subjects: gastrointestinal stromal tumor -- imatinib mesylate -- immune cells -- immunotherapy; Oncology -- Periodicals; 616.994
• DOI: 10.1097/CCO.0000000000000201
• Languages: English
• ISSNs: 1040-8746

Abstract

Abstract : Purpose of review: This article reviews the current literature on tumor-infiltrating immune cells in gastrointestinal stromal tumor (GIST), and the current status and prospects of effective immunotherapeutic strategies. Recent findings: Tumor-infiltrating immune cells populate the microenvironment of GISTs; the most numerous are tumor-associated macrophages (TAMs) and CD3 + T cells. TAMs have not been shown to have a relationship with the biological behavior of GISTs; however, the number of CD3 + T cells correlates with better outcomes. The prognostic significance of tumor-infiltrating neutrophils, natural killer cells, CD4 + T cells, CD8 + T cells, and Treg cells remains unknown. Imatinib mesylate achieves a clinical response in 80% of patients with GIST. Its antitumor mechanism is partially immune mediated. The combination of imatinib and interferon-α has been shown to be effective against GIST – it eradicates tumor cells including those that are drug resistant. Preclinical trials including cytotoxic T lymphocyte-associated antigen 4 blockade, anti-KIT antibody, and the generation of designer T cells have shown promising therapeutic effect in animal models of GIST. Summary: GIST contains many tumor-infiltrating immune cells and should be susceptible to immunotherapy; early clinical and preclinical trials have shown promising results that should lead to new investigations and effective forms of direct and synergistic therapies.