Combining immunotherapy and natural immune stimulants: mechanisms and clinical implications
The development of immunotherapy (IT) represents one of the most promising advances in oncology in the past several years. Indications for IT have expanded rapidly, and a growing number of patients with an increased variety of cancer diagnoses are being treated with these agents. At the same time, the use of complementary and integrative therapies among cancer patients is widespread (Tara et al. 2018), and many patients do not disclose or discuss these therapies with their physicians (Richardson et al. 2000). Patient use of nutritional supplements may include items that are considered natural immune stimulants (NIS). Our understanding of how NIS use may affect people who are being treated with IT is in its infancy. To the author’s knowledge, there are no clinical trials, and extremely limited preclinical data, examining the effect of combining IT and NIS. It is critical to consider the shared mechanisms of IT and NIS and how this combination may affect patients. We offer...
The Research Fellowship in Complementary and Integrative Health (5T32AT003378-12) from the National Center for Complementary and Integrative Health provides salary support for Dr. Hill.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to disclose regarding this review.
- Boutsikou E, Domvri K, Hardavella G et al (2018) Tumour necrosis factor, interferon-gamma and interleukins as predictive markers of antiprogrammed cell-death protein-1 treatment in advanced non-small cell lung cancer: a pragmatic approach in clinical practice. Ther Adv Med Oncol 10:1758835918768238. https://doi.org/10.1177/1758835918768238 CrossRefGoogle Scholar
- Cai X, Xu Y, Lin X (2006) Effects of radix Astragali injection on apoptosis of lymphocytes and immune function in patients with systemic lupus erythematosus. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi Chin J Integr Tradit West Med 26:443–445Google Scholar
- Callahan MK, Yang A, Tandon S et al (2011) Evaluation of serum IL-17 levels during ipilimumab therapy: correlation with colitis. ASCO Meet Abstr 29:2505Google Scholar
- Dong J, Gu H, Ma C et al (2005) Effects of large dose of Astragalus membranaceus on the dendritic cell induction of peripheral mononuclear cell and antigen presenting ability of dendritic cells in children with acute leukemia. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi Chin J Integr Tradit West Med 25:872–875Google Scholar
- Keir ME, Butte MJ, Freeman GJ, Sharpe AH (2008) PD-1 and its ligands in tolerance and immunity. Annu Rev Immunol 26:677–704. https://doi.org/10.1146/annurev.immunol.26.021607.090331 CrossRefGoogle Scholar
- Tara A, Berman, Christina M, Annunziata AB (2018) Oncology patient and practitioner experience with complementary/alternative medicine at the NIH Clinical Center. In: 2018 ASCO annual meeting abstracts. Oncology patient and practitioner experience with complementary/alternative medicine at the NIH Clinical CenterGoogle Scholar
- Vetvicka V, Vetvickova J (2014) Natural immunomodulators and their stimulation of immune reaction: true or false? Anticancer Res 34:2275–2282Google Scholar
- Yang S-P, Dong H, Wu Y-C (2008) Clinical effect of milkvetch extract oral liquid in preventing and treating children’s recurrent respiratory tract infection. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi Chin J Integr Tradit West Med 28:544–547Google Scholar
- Zhao XZ (1992) Effects of Astragalus membranaceus and Tripterygium hypoglancum on natural killer cell activity of peripheral blood mononuclear in systemic lupus erythematosus. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi Chin J Integr Tradit West Med 12:669–671, 645Google Scholar