Finally, Finn and Beatty suggest a new role for immunotherapy
as a modality of cancer prevention. After all, the
immune system should have an easier job when transforming
cells are still at a premalignant stage or when the
actual tumor burden is minimal and the biology has not
had the time to evolve into a more immune suppressive
and immune evasive phenotype.
Several topics remain to be discussed that were beyond
the purpose of this collection. For instance, the need to
identify useful predictive and prognostic biomarkers that
are highly needed to tailor the right combination of
therapies that are now being selected rather according
to an empirical process. Notably, re-appreciation of
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classical MHC expression but also the expression of
non-classical MHC molecules, all of which are associated
with immune regulation, will be essential. Next, it will
be important to redefine the role of shared tumor antigens
as this topic has been somewhat overshadowed by
the focus on neo-antigens. Also it is becoming increas-
ingly recognized that B cells may play a more important
role in cancer immune rejection than previously appreciated
and more work will need to focus on this topic in
the future.
A key question remain about how immunotherapy can
expand to other tumor types with lower immunogenic
potential exploiting novel therapeutic strategies and combinations
such as the abscopal effect induced by radiation
therapy. And finally, how can novel technologies such as
nanotechnology, integrated approaches and novel imaging
techniques can optimize cost/effectiveness of correl-
ative studies for more efficient identification of useful
biomarkers.