Evaluating a Cancer Patient’s Immune System

As we have previously written, most patients with cancer are treated with some combination of either surgery, chemotherapy, or radiation treatment. The patient’s immune system is often ignored during the current treatment of cancer.  We have published numerous papers on the importance of studying and treating the cancer patients immune system also know as host immunity.

As previously published in an editorial in 2005, a cancer patient’s immune system should be evaluated before any treatment is started.  There are several ways to measure the immune system and measure the response of the immune system after treatment (Elliott et al., 2005):

  1. DTH (delayed-type hypersensitivity)
  2. Proliferation assays
  3. Chromium release assay
  4. Elispot
  5. Cytokine flow cytometry (CFR)
  6. Tumor antigen peptide tetramer-binding assay
  7. Clinical observation of response

It is important to determine if a cancer patient has an overall good immune system, especially to their own tumor-associated antigens (TAA).  If a patient has a good immune system and their immune system is able to recognize their tumor, then they have a better outcome (Head et al., 1993). This concept applies not only to breast, but several cancers including lung, stomach, pancreas, and colon.

Our research as well as previous studies support the finding that evaluating a cancer patient’s immune system before, during, and after treatment is important to determine if there was a response to treatment.  Two independent researchers decades apart demonstrated the positive relationship between a person’s immune system and survival. Riesco et al., 1970 demonstrated that measuring a cancer patients total lymphocyte count before treatment could determine a patient’s survival. Fumagalli et al, 2003 also showed how a cancer patient’s lymphocyte count determines their overall survival.

At our center, we believe in supporting a cancer patient’s immune system.  In our cancer patients, we measure a total immune profile and a lymphocyte blastogenesis assay.  These two tests give us detailed information on a cancer patients own immune system including the number of T cells and B cells which are important cells to fight infection and cancer.  These tests also lets us know if the cancer patient’s immune system can recognize certain cancer markers.  In some cases, we are actually able to see if a cancer patient’s immune system can recognize their own cancer!

While we are a breast center, we see and treat patients with other cancers.  Our goal is to help support a patient’s immune system so that they can use their own immune system to help fight off their current cancer and prevent any recurrence of cancer.  We believe immunologic therapy can compliment traditional treatment for cancer, but evaluating a cancer patient’s immune system is important and should not be ignored!

Stay tuned……..more to come on understanding a cancer patient’s immune system!

Robert L Elliott M.D., Ph.D.

Catherine Baucom M.D., Ph.D.

REFERENCES:

Elliott RL & Head JF. 2005. Host Immunity Ignored in Clinical Oncology: A Medical Opinion. Cancer Biotherapy & Radiopharmaceuticals. 20(2):119.

Head JF, Wang F, Elliott RL, et al. 1993. Assessment of Immunological competence and host reactivity against tumor antigens in breast cancer patients: Prognostic value and rationale of immunotherapy development. Ann NY Acad Sci-Fi. 690:340.

Riesco A. 1970. Five-year cancer cure: Relation to total amount of peripheral lymphocytes and neutrophils. Cancer. 25:135.

Fumagalli LA, Vinke J, Hoff W, et al. 2003. Lymphocyte counts independently predict overall survival in advanced cancer patients: A biomarker for IL-2 immunotherapy. Immunotherapy. 26:394.

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