Immunotherapy for gastric premalignant lesions and cancer.
Chronic atrophic gastritis, a precancerous change for gastric cancer, shows a loss of appropriate glands, Helicobacter pylori infection and autoimmune gastritis being the two main etiologic factors. While H. pylori eradication is the mandatory treatment for the former, no etiologic treatment is available for the latter, in which a Th1-type response, modulated by Tregs and Th17 cells, is involved. H. pylori-related atrophic gastritis is a risk factor for gastric adenocarcinoma, while autoimmune atrophic gastritis is also linked to a substantial risk of gastric type I carcinoid, related to the chronic stimulus exerted by hypergastrinemia on enterochromaffin-like cells. Several studies have been published on gastric cancer treatment through an active specific immunotherapy, aimed at improving the immunoregulatory response and increasing the circulating tumor-specific T cells. No study on immunotherapy of carcinoids is available but, in our experience, the administration of an antigastrin 17 vaccine induced carcinoid regression in two out of three patients treated.
Department of Surgical, Oncological & Gastroenterological Sciences, Policlinico Universitario, Via Giustiniani 2, 35128 Padova, Italy.
Valerio
V
Zorzetto
Gemma
G
Maddalo
Daniela
D
Basso
Fabio
F
Farinati
D000230:Adenocarcinoma / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols; D019496:Cancer Vaccines / Q000494:pharmacology / Q000627:therapeutic use*; D019861:Enterochromaffin-like Cells / Q000187:drug effects* / Q000473:pathology; D005755:Gastrins / Q000037:antagonists & inhibitors / Q000276:immunology / Q000494:pharmacology / Q000627:therapeutic use*; D005757:Gastritis, Atrophic / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000639:trends; D011230:Precancerous Conditions / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D012306:Risk; D013274:Stomach Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*
D019496:Cancer Vaccines; D005755:Gastrins; C482698:gastrin immunogen