Hôpital Européen Georges Pompidou, Service d’immunologie biologique, 20 rue Leblanc, 75015 Paris
Équipe INSERM 15, UMRS1138, « Immunologie et Cancérologie intégrative », Centre de recherche des Cordeliers, Paris
After decades of controversy, the existence of natural anti-tumor immunity is definitively established and fundamental data have elucidated many mechanisms of tumor escape from the immune response. Beyond mechanisms involving the tumor cell, powerful lymphocyte inhibitory mechanisms have been demonstrated. These data have led to the emergence of new therapeutic strategies. Monoclonal antibodies directed against inhibitory lymphocyte receptors or their ligands (CTLA-4, PD-1/PD-L1) have demonstrated significant anti-tumor activity in many types of cancers. Thus, this effective treatment does not target the tumor cell but attempts to stimulate the natural defenses. This is a paradigm shift. For the first time, long-term stabilization and even cures for cancers that were considered incurable are being considered. Another immunotherapy strategy using “drug cells” is revolutionizing the treatment of B hematological malignancies. The natural cytotoxic activity of the patient's own lymphocytes is used in therapy after redirecting the antigenic recognition of the lymphocytes. The combination of a considerable increase in our fundamental knowledge of immunology and the technological means to manipulate the immune response suggests that in the coming years, there will be a significant gain in efficacy and less toxicity.