3
T-cells
use their TCRs to identify the tumor
antigens on the surface of the
cancer cells
.
But the tumor activates another T-cell receptor.
This triggers an inhibitory signal for the T-cells:
their reaction is blocked and they no longer
attack the tumor. This is where immunotherapy
intervenes.
Specific antibodies
are injected
into the patient in order to block receptor acti-
vation – and thus halt the negative signals to
the T-cells. They can now successfully combat
the tumor.
1
In tissue close to the
melanoma
,
dendritic cells
pick up tumor antigens
and present them on their surface. These
cells migrate via the lymph vessels to the
lymph nodes
.
2
In the
lymph nodes
, the
dendritic cells
present the tumor antigen to naive
T-cells
.
These dock with their T-cell receptors
(TCRs) to the tumor structure and are acti-
vated. They travel via the lymph vessels to
the
melanoma
.
Lymph nodes
Melanoma
Dendritic
cells
Immunotherapy with
specific antibodies
Checkpoint blockade: raising the barrier to
unleash the immune response
Tumors such as melanomas can send inhibitory signals that suppress the response of the immune system. This is where the new
therapeutic approach of the checkpoint blockade comes in: specific antibodies cancel the command and allow the immune system
to resume its attack on the tumor.
TCR
TCR
naive T-cell
Tumor cell
activated T-cell
Cover story
MEDICINE
Bayer research 28 July 2015
15
One of the work areas in the collaboration is focused on brain
tumors. “Our group has already developed a first targeted immu-
nization approach against a common feature of gliomas, which is
now being tested in a clinical study,” explains Professor Michael
Platten of the DFKZ. As leader of the Neuro- and Brain Tumor
Immunology Group, he is confident that the general approach of
immunotherapies will deliver numerous opportunities. “I expect
immunotherapy to become firmly established in cancer treat-
ment.” Unlike chemotherapy and radiation therapy, which are
concluded after a given treatment cycle, immunotherapy can
have a long-term effect: during treatment, the immune system
learns how to fight off the cancerous cells under its own power
in the long term. T-lymphocytes have the potential to repress
the tumor, and memory cells can also be formed. “After success-
ful treatment, a patient is protected, at least against recurrent
malignancies: if cancer cells that have lain hidden in the body
should resurface, the trained immune system can now hunt
down and destroy them,” Aswad explains.
Another advantage is that the tumors are less likely to de-
velop resistance to the treatment, in contrast to chemotherapy
drugs. “What’s more, cytostatic drugs do not distinguish between
healthy and foreign tissue. These chemicals attack all cells that
divide and multiply at a particularly rapid pace,” Kreft says. That
includes tumor cells, but also hair follicles, the mucous mem-
branes and the nail beds of the fingers and toes. This causes
the familiar side effects: patients lose their hair, their sense of
taste changes, their nails fall off. “In contrast, checkpoint inhibi-
tors are much more targeted, but still act throughout the entire
body,” Kreft continues. As a result, patients are often less affected
by nausea, for example, and do not feel as exhausted as they
do after radiation treatment. “The checkpoint blockade is not a
wonder drug, however,” Aswad warns. Like virtually all medical
treatments, it also poses certain risks. “The stimulated immune
system can sometimes also turn on healthy tissue. Autoimmune
responses of this kind can cause severe inflammation in the in-
testines, liver or skin. Patients must therefore be monitored very
closely and frequently,” Aswad says.
Nevertheless, the Bayer researchers are convinced that there
is a high chance that the benefits and the treatment potential
of checkpoint inhibition will outweigh its risks. First therapies
What is the goal of your collaboration with Bayer?
Our goal is the development of antibody-based therapeutics for
cancer immunotherapy based on two novel immune checkpoint
regulators that we discovered at Compugen. These novel pro-
teins are involved in immune regulation, and are expressed in the
tumor microenvironment in various cancers on both tumor and
infiltrating immune cells. Targeting these proteins with antibody
therapeutics could overcome their suppressive effect within the tu-
mor microenvironment and result in a robust anti-tumor immune
response.
How do both Bayer and Compugen profit from the collaboration?
In this collaboration Bayer and Compugen are working together
as a unified team on the development of therapeutics, through its
broadly applicable predictive discovery capabilities. Both groups
contribute their specific scientific knowledge in the field of im-
mune checkpoint blockade and each company shares expertise and
knowledge with the other. In the crowded field of immuno-oncolo-
gy, many in the industry are focused on known immune checkpoint
“ We target novel immune
checkpoints”
Zurit
Levine
targets. We, however, develop drugs targeting novel immune
checkpoints to generate first-in-class therapeutics, which could
increase response rates or extend the range of cancer indications
treated, and provide a source for effective drug combinations.
How do you think immunotherapy in general and checkpoint
blockade specifically will influence cancer therapy?
The blockade of immune checkpoints unleashes the potential of
the anti-tumor immune response in a fashion that is transforming
cancer therapeutics. Checkpoint-blocking antibodies have lately
demonstrated impressive clinical benefits and long-term survival,
even for end-stage patients, raising hopes that this novel ap-
proach might lead to effective therapeutic strategies and valuable
additions in the fight against cancer. However, current therapies
appear to address only a small percentage of patients. Therefore,
the availability of monoclonal antibody drugs addressing addi-
tional novel checkpoint targets could significantly broaden the
applicability of this breakthrough approach – specifically in cancer
indications where current immunotherapies are not efficacious.
Dr. Zurit Levine is Vice President of Research and Discovery at
Compugen Ltd. in Israel. research spoke to the scientist about the
collaboration with Bayer and the future of cancer therapy.
Greater quality of life for cancer patients
during treatment
MEDICINE
Cover story
16
Bayer research 28 July 2015