Gynecology and Obstetrics Research · Vol. 4, No. 2 · 2017 · pp. 41–43 · e-ISSN 2377-1542

Tumor Conditioning Regimens: An Evolution in Cancer Treatment that Relies on Short-Term Sacrifice for Long-Term Gain

Erin Bishop, Ramani Ramchandran

Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USAUnited States
Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Department of Pediatrics, Division of Neonatology, Developmental Vascular Biology Program, Children’s Research Institute, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USAUnited States

DOI: https://doi.org/10.17140/goroj-4-143 · Published 2017-12-20 · Licence: https://creativecommons.org/licenses/by/4.0 · © 2017 The Author(s)

Also available as PDF (figures and tables appear in the PDF).

Abstract

In this commentary, the authors discuss a new concept for tumor treatment, which is based on observations from published studies and clinical practice protocols. This new treatment regimen, which we coin “Tumor Conditioning Regimens,” abbreviated as TCRs is based on the idea that by conditioning tumors with oxygenation, increasing mutation loads or normalizing vessels, we create a permissive environment for tumor growth in the short-term, which will eventually in the long run benefit tumor regression.

Acknowledgments

that additional pre-clinical research using appropriate model systems that can mimic perfusion will help gain evidence for the We thank scientists who work with us and patients who have feasibility of this strategy.

been treated under our care for inspiring the ideas that are discussed in this document. We also thank Dr. Denise Uyar, Di- A second example of the TCR concept involves the host vision Chief of Gynecology Oncology in Department of OBimmune system. Molecules on immune cells, or “checkpoints,” GYN at MCW for providing critical feedback on this document. are used to initiate or stop immune responses to foreign cells Dr. Bishop is supported by Laura’s Smile Foundation and the or self. T-cells express a checkpoint protein called programmed Wisconsin Ovarian Cancer Alliance. Dr. Ramchandran is partly cell death protein-1 (PD-1) and when PD-1 binds to the prosupported by NIH grants (HL123338, HL136423, HL033833, tein programmed death ligand-1 (PD-L1) on normal cells, this HL120585), and institutional support from Medical College of signals the T-cell to not attack the normal cell.12 Some cancer Wisconsin (MCW), Children’s Research Institute and Departcells utilize this host defense mechanism to their advantage by ments of Pediatrics and Obstetrics and Gynecology (OBGYN). carrying large amounts of PD-L1 protein that keep the immune Both investigators are supported by Women’s Health Research system from attacking them.13 Checkpoint inhibitors are used in Fund in the Department of OBGYN at MCW.

many types of cancer and are being actively investigated for use in ovarian cancer. In melanoma, it has been shown that patients

Conflicts Of Interest

with a high mutation burden have increased neo-antigen formation and subsequent increase in response to checkpoint inhibi- The authors declare no conflicts of interest, and opinions extors.14 Similar findings have been observed in GB patients and pressed here are based on facts from scientific papers. patients with metastatic tumors with a high frequency of somatic mutations.15 Due to these findings, DNA damaging agents, such

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