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World J Gastroenterol. Dec 14, 2013; 19(46): 8531-8542
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8531
Immunotherapy for colorectal cancer
Shigeo Koido, Toshifumi Ohkusa, Sadamu Homma, Yoshihisa Namiki, Kazuki Takakura, Keisuke Saito, Zensho Ito, Hiroko Kobayashi, Mikio Kajihara, Kan Uchiyama, Seiji Arihiro, Hiroshi Arakawa, Masato Okamoto, Jianlin Gong, Hisao Tajiri
Shigeo Koido, Toshifumi Ohkusa, Kazuki Takakura, Keisuke Saito, Zensho Ito, Hiroko Kobayashi, Mikio Kajihara, Kan Uchiyama, Seiji Arihiro, Hisao Tajiri, Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Chiba 277-8567, Japan
Shigeo Koido, Sadamu Homma, Department of Oncology, Institute of DNA Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan
Masato Okamoto, Division of Cellular Signaling, Institute for Advanced Medical Research, Keio University School of Medicine, Tokyo 160-8582, Japan
Shigeo Koido, Yoshihisa Namiki, Institute of Clinical Medicine and Research, The Jikei University School of Medicine, Chiba 277-8567, Japan
Hiroshi Arakawa, Department of Endoscopy, The Jikei University School of Medicine, Chiba 277-8567, Japan
Jianlin Gong, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, United States
Author contributions: Koido S, Ohkusa T, Homma S, Namiki Y, Takakura K, Saito K, Ito Z, Kobayashi H, Kajihara M, Uchiyama K, Arihiro S, Arakawa H, Okamoto M, Gong J and Tajiri H contributed equally to the manuscript, drafting the article and revising it critically for important intellectual content, and approved the final version for publication.
Supported by Grants in Aid for Scientific Research (C) from the Japanese Ministry of Education, Culture, Sports, Science and Technology
Correspondence to: Shigeo Koido, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa-shi, Chiba 277-8567, Japan. shigeo_koido@jikei.ac.jp
Telephone: +81-4-71641111 Fax: +81-4-71633488
Received: September 5, 2013
Revised: October 22, 2013
Accepted: November 18, 2013
Published online: December 14, 2013
Processing time: 103 Days and 18.4 Hours
Abstract

The incidence of colorectal cancer (CRC) is on the rise, and the prognosis for patients with recurrent or metastatic disease is extremely poor. Although chemotherapy and radiation therapy can improve survival rates, it is imperative to integrate alternative strategies such as immunotherapy to improve outcomes for patients with advanced CRC. In this review, we will discuss the effect of immunotherapy for inducing cytotoxic T lymphocytes and the major immunotherapeutic approaches for CRC that are currently in clinical trials, including peptide vaccines, dendritic cell-based cancer vaccines, whole tumor cell vaccines, viral vector-based cancer vaccines, adoptive cell transfer therapy, antibody-based cancer immunotherapy, and cytokine therapy. The possibility of combination therapies will also be discussed along with the challenges presented by tumor escape mechanisms.

Keywords: Colorectal cancer; Cytotoxic T lymphocyte; Dendritic cell; Immunotherapy; Vaccine

Core tip: The prognosis for patients with recurrent or metastatic colorectal cancer (CRC) is extremely poor. Immunotherapy may be effective for treating CRC patients and/or preventing relapse. The immunotherapeutic approaches for CRC, including peptide vaccines, dendritic cell-based cancer vaccines, whole tumor cell vaccines, viral vector-based cancer vaccines, adoptive cell transfer therapy, antibody-based cancer immunotherapy, and cytokine therapy have been demonstrated. The blockade of multiple immune regulatory checkpoints combined with immunotherapy and/or conventional chemotherapy may be effective in treating patients with advanced CRC.