Dr. Ansell on Strategies to Address Immune Evasion in Lymphoma

Stephen M. Ansell, MD, PhD, chair of the Lymphoma Group at Mayo Clinic, discusses strategies addressing immune evasion in patients with lymphoma.

One of the most successful strategies to overcome immune evasion is to prevent T cell exhaustion. When T cells get activated and produce proteins such as PD-1, it puts them at risk for being suppressed if the ligand PD-L1 or PD-L2 signals through PD-1, Ansell explains. Other receptors such as TIM-3 and LAG-3 are important, Ansell adds, and those begin to increase as the T cell becomes exhausted. Strategies to keep the immune system engaged involve blocking these negative systems. Blocking PD-1 has already proved to be successful in lymphoma, but there are new trials blocking TIM-3 and LAG-3, Ansell says.

Another strategy is getting the macrophages, which are negatively influencing the immune system, to turn on the tumor. The tumor puts a protein on the cell surface that signals to the immune system it is a good cell. If that protein is covered, then the immune system will attack it, causing cell death, Ansell explains.