title: The importance of correctly timing cancer immunotherapy.
abstract: The treatment options for cancer-surgery, radiotherapy and chemotherapy-are now supplemented with immunotherapy. Previously underappreciated but now gaining strong interest are the immune modulatory properties of the three conventional modalities. Moreover, there is a better understanding of the needs and potential of the different immune therapeutic platforms. Key to improved treatment will be the combinations of modalities that complete each other's shortcomings. Area covered: Tumor-specific T-cells are required for optimal immunotherapy. In this review, the authors focus on the correct timing of different types of chemotherapeutic agents or immune modulators and immunotherapeutic drugs, not only for the activation and expansion of tumor-specific T-cells but also to support and enhance their anti-tumor efficacy. Expert opinion: At an early phase of disease, clinical success can be obtained using single treatment modalities but at later disease stages, combinations of several modalities are required. The gain in success is determined by a thorough understanding of the direct and indirect immune effects of the modalities used. Profound knowledge of these effects requires optimal tuning of immunomonitoring. This will guide the appropriate combination of treatments and allow for correct sequencing the order and interval of the different therapeutic modalities.
authors: a Department of Medical Oncology , Leiden University Medical Center , Leiden , The Netherlands.|b Department of Immunohematology and Blood Transfusion , Leiden University Medical Center , Leiden , The Netherlands.
authors: Elham
authors: E
authors: Beyranvand Nejad
authors: a Department of Medical Oncology , Leiden University Medical Center , Leiden , The Netherlands.
authors: Marij J P
authors: MJ
authors: Welters
authors: b Department of Immunohematology and Blood Transfusion , Leiden University Medical Center , Leiden , The Netherlands.
authors: Ramon
authors: R
authors: Arens
authors: a Department of Medical Oncology , Leiden University Medical Center , Leiden , The Netherlands.
authors: Sjoerd H
authors: SH
authors: van der Burg
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000276:immunology / Q000627:therapeutic use; D019496:Cancer Vaccines / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000276:immunology / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D009369:Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology; D013997:Time Factors; D014611:Vaccination / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D007155:Immunologic Factors
keywords: Cancer; combination therapy; immunomonitoring; immunotherapy; timing