Immunotherapy for Epithelial Ovarian Cancer - Immunological Background, Critical Review of Methods and Future Perspectives

Ovarian cancer is one of the most fatal female neoplasms due to its aggressive behavior and late diagnosis. Despite improvments of the surgical approach and the use of chemotherapy, the survival rate observed in patients with advanced ovarian cancer is still unsatisfactory. The presence of cancer modulates adversely the immunological response of the host. Immunosurveillance over the tumor could be at least partly restored by the use of immunotherapy based either on techniques which allow to recognize and directly inhibit tumor cells, or on methods which mobilize and augment an anti-tumor host response. The first kind of strategy uses monoclonal antibodies directed against cancer specific antigens (CA-125) and molecules responsible for tumor growth and spreading (HER-2, EGFR-1, VEGF). The second kind of strategy modifies the host immune status by use of different techniques. Some of them are based on the administration of cytokines given in order to facilitate anti-tumor immunity. Recent studies have explored novel techniques which use hybrid cytokine/monoclonal antibodies targeted to specific cancer antigens, cancer antigen-pulsed and cancer cell-fused dendritic cells, or modification of regulatory or cytotoxic T cells. New methods of immunotherapy appear on the horizon, however, their efficacy still awaits confirmation in clinical trials.