Page 90 - Bio Engineering Approaches to Cancer Diagnosis and Treatment

88 CHAPTER 4 Immunotherapy

significantly more successful through evaluating the results of progression-free sur-
vival (PFS), median overall survival (OS) and the presence or absence of secondary
malignancies in the long-term follow up [51].
In a phase II clinical study, Wang et al. has successfully managed using of chemo
immunotherapy to receive good results for Mantle Cell Lymphoma treatment. In this
clinical study, a relatively high chemo immunotherapy regimen with Retuximab with
Hyper-CVAD (Hyper-CVAD chemotherapy consist of combination of drugs) was
used [52].
Knutson et al. was also conducted a clinical study in 2016 on 48 women with
+
metastatic HER2 breast cancer. They have reported that adding Trastuzumab to the
+
chemotherapy regimen increases the survival rate of patients with HER2 breast can-
cer. In this study, patients received Paclitaxel, Carboplatin, and Trastuzumab. Their
results have shown that the use of combination therapy (in here chemo immuno-
therapy) has been effective in inducing an adaptive immune system against antigens
released by tumor cells [53].
In another study by Spanish researchers in 2019, the effect of Nintedanib,
Docetaxel, anti-PD-1, and anti-PD-L1 has been proven to be a therapeutic regimen
for the treatment of advanced lung adenocarcinoma [54].

4.5 Antibody-drug conjugate

The mid-1990s saw antibodies progress tremendously as drugs, with over 60 drugs
produced based on antibodies. Antibodies are one of the most developed class of
drugs that have a high potency in cancer treatments, autoimmune diseases and
chronic inflammations [55]. In this chapter, the benefits of antibodies that are conju-
gated with drugs have discussed.
Problems have always existed in the traditional method of dealing with cancer.
These methods have mostly relied on chemotherapy causing systemic cytotoxicity.
The first inklings in monoclonal antibody production was altered the cancer therapy
methods into new approaches, which was selective treatment [56].
ADCs are considered to be useful in cancer treatment, due to their capabilities
in monoclonal antibody specification, the growth in linker fabrication strategies and
possibility of toxic drug usage [57]. Antibodies in ADCs consist of chimeric (i.e.,
a combination of genetic materials from other species such as rabbit, mice, etc.) or
humanized antibodies that become attached to the toxic drug by linker and cause
local release of payload inside of antigen positive cells. Hence, the select ability of
antibody and targeted release makes ADCs production as an interesting topic [58]. In
Fig. 4.10, a schematic diagram reflects the main idea of the topic.
In 1913, the first steps of delivering a cytotoxic drug into cancerous cells with
the usage of targeting materials was invented by Ehrlich [59]. Afterwards in 1970,
antibodies were armed with a toxic agent as a means to kill specific cells. In 2000,
the first commercialized ADC (gemtuzumab ozogamicin) against acute myeloid
leukemia (AML) was approved, however in 2010 this ADC showed a high rate of