The body’s immune system
The best therapy for cancer.
The body’s own immune system is so far the only way to cure cancer. This is because even after the removal of a locally occurring tumor – e.g. a prostate carcinoma – tumor cells are present throughout the patient’s body. These microscopic cells cannot be visualized by imaging and have not yet been treated. They can remain inactive in the body for years and decades and form the basis for the later growth of metastases, larger clusters of tumor cells. The vast majority of men with prostate cancer die from metastases rather than their primary tumor in the prostate.
Nevertheless, established therapies for prostate cancer are focused on treating the primary tumor. Surgery, radiation and chemotherapy actually damage the immune system instead of supporting it. Treatment of cancer cells scattered throughout the body has not routinely taken place.
Immunotherapy
A treatment to support the body’s own immune system in the fight against tumor cells.
However, it has been known for many years that there are also treatment fractions for cancer that support the body’s own immune system in fighting tumor cells. These procedures show the way in which they kill tumor cells, namely through apoptosis and necrosis. These include procedures such as irreversible (IRE) and reversible electroporation (ECT = electrochemotherapy), but also photodynamic therapy (PDT), a much older procedure that has been well studied scientifically in terms of its antitumor immune effects 1 .
Making prostate cancer “visible” to the immune system
The immune system can recognize released tumor antigens.
Tumors are recognized by the immune system via tumor antigens, recognition molecules that are located, for example, on the surface of tumor cells. During treatment with tissue ablation procedures such as IRE, ECT and PDT, these tumor antigens are released en masse and recognized by the immune system – just like a vaccination in which inactive viruses are injected.
As a result, even tumors that are difficult for the immune system to detect, such as prostate carcinoma, can be made “visible”.
Enhancement of the Immune Response by Immunotherapy
The resulting immune response against the tumor and cancer cells scattered throughout the body can be enhanced by immunotherapeutics. A wide variety of substances play a role in this.
It has been known for about 100 years that inflammation occurring simultaneously with tumors can lead to spontaneous remission1 . For bladder tumors, inducing infection with the tuberculosis vaccine Bacillus Calmette-Guérin (BCG) is established as standard therapy. Also oncolytic viruses 2 , dendritic cells, cytokines such as interleukin-6, and suppression of T-regulatory cells by low-dose cyclophosphamide 3 can enhance the immune response against tumor cells.
Modern immunotherapeutics such as check-point inhibitors (e.g. PD1 inhibitors – Keytruda©) act more specifically by enhancing the body’s immune response by blocking specific receptors.
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VITUS immunotherapy
Pioneering integrated therapy concepts for better survival in prostate cancer
At the VITUS Prostate Center we use the modern possibilities of immunotherapy to destroy prostate cancer not only locally in the prostate but cancer cells throughout the body, with the aim of preventing the formation of metastases and tumor recurrence.
Shown is the combination of treatment of a primary tumor (here with PDT) with immunostimulants. Intratumoral injection of various Toll-like receptor (TLR) ligands: Bacillus Calmette-Guerin (BCG), Mycobacterial cell-wall extract (MCWE), OK432, Zymosan, Schizophyllan (SPG), or Corynebacterium parvum (CP), effectively activates dendritic cells (DCs) and increases antigen presentation and local inflammation. Injection of various cytokines, such as granulocyte-macrophage colony-stimulating factor (GMCSF), granulocyte colony-stimulating factor (GCSF), and tumor necrosis factor-α (TNFα), results in enhanced
Infiltration by macrophages, activation of neutrophils and direct destruction of tumor vessels.
