What is the future of immunotherapy?

Immunotherapy represents a new paradigm in cancer care. It’s really an entirely new mechanism for treating cancer. We’re not targeting the tumor cells; instead, we’re targeting the immune system.

I encourage patients to talk with their physicians about innovative treatment options and consider participating in clinical trials so we can move the field forward. Together, we can unlock the promise of immunotherapy.


Diagnosis and management of Lynch syndrome


A personalised approach to lifelong gene-specific management for people with LS provides many opportunities for cancer prevention and treatment.

What surveillance should these patients undergo?

  • Colonoscopic surveillance should be performed every 2 years starting at age 25 years for MLH1, or MSH2 pathogenic variant carriers, or age 35 years for MSH6, or PMS2 pathogenic variant carriers.
  • Endoscopic lesions can be difficult to recognise due to a high frequency of flat non-polypoid morphology, and high-quality colonoscopy is essential.
  • Gynaecological surveillance has no proven benefit.
  • Aspirin reduces long-term colorectal cancer (CRC) risk by approximately 50%. Recommended doses include 150 mg ODonce daily or 300 mg ODonce daily for patients with BMIbody mass index >30.

What surgical treatments are recommended?

  • Women should be counselled on prophylactic hysterectomy and bilateral salpingo-oopherectomy from age 40 years (MLH1, MSH2 and MSH6 variant carriers).
  • There is a gene-specific approach to surgical management of CRC which takes in to account other patient factors.

What systemic oncological treatments are recommended?

  • Chemoprophylaxis with daily aspirin for at least 2 years is recommended in patients <70 years old diagnosed with LS to reduce long-term CRC risk.
  • Personalised systemic anticancer therapy is feasible for locally advanced or metastatic disease associated with LS, and may respond very well to relatively novel checkpoint inhibition immunotherapy.

Is There a Lynch Syndrome Vaccine on the Way?

Lynch Syndrome, a genetic condition affecting around 1 million Americans annually, increases a person’s risk of developing colorectal cancer (CRC) to 20% – 80%.

As a result, Lynch Syndrome patients must complete yearly preventive screenings. However, developing a Lynch Syndrome vaccine could change the narrative for patients, reducing screenings and – more importantly – lowering risks for Lynch Syndrome-related cancers. 

“The advances in vaccine technologies, such as Lynch Syndrome, is a promising field of research that has the potential to reduce the risk of developing cancer, thereby preventing disease and modifying surveillance regimens for high-risk patients,” said David Fenstermacher, Senior Director of Research & Medical Affairs at the Colorectal Cancer Alliance.


Lynch syndrome cancer vaccines: A roadmap for the development of precision immunoprevention strategies

Safe and effective cancer prevention strategies are critically needed to improve the life quality and longevity of LS and other Hereditary Cancer Syndrome carriers. The era of precision oncology driven by recent technological advances in tumor molecular profiling and a better understanding of genetic risk factors has transformed cancer prevention approaches for at-risk individuals, including LS carriers. 

Here, they discuss recent advances in precision cancer immunoprevention approaches, emerging enabling technologies, research gaps, and implementation barriers toward clinical translation of risk-tailored prevention strategies for LS carriers.


The success of FSP neoantigen(mutation)-based cancer vaccines for LS cancer prevention will hopefully demonstrate the potential marketability of cancer preventive vaccines in the next decade, which will bring an increasing interest from the private sector and can lead to the partnership opportunities between academia, government, and industry for the betterment of quality of life for LS and other high-risk populations.

Immunotherapy and… Nothing Else? Studies Test Potential Paradigm Shift in Cancer Treatment

The leaders of those trials and other experts stressed that much more research is needed before this treatment approach becomes part of everyday cancer care. But they agreed that the findings so far are highly encouraging.

The most recent results come from a 35-patient clinical trial conducted at MD Anderson Cancer Center. Most patients in the trial had locally advanced colorectal cancer. Perhaps most important, however, was that all participants’ tumors had specific genetic changes—known as MSI-high or dMMR—that make them particularly good candidates for immunotherapy.

thisisGO – Lynch Syndrome

thisisGO.ie is an online personalised resource for you and yours who have been impacted by a gynaecological cancer.

Also an excellent resource for Lynch Syndrome.

Trials Test Vaccines for Prevention or Delay of Cancers Associated with Lynch Syndrome

Researchers have recruited the first vaccine candidates to one of two new prevention trials that seek to immunize high-risk individuals against Lynch syndrome, the most common cause of hereditary colorectal cancer. Individuals who inherit the condition have an estimated lifetime risk as high as 80% for developing one of these malignancies, as well as an above-average risk for cancers arising in other organs, often at an early age, and regardless of race or gender.

The Nous-209 vaccinenamed partially for the number of neoantigens or “new” antigens it contains, and in part for the Switzerland-based company (Nouscom) that developed it—employs what investigators call “a brute force” approach. The vaccine contains 209 bits and pieces of cancer-specific neoantigens expressed only in premalignant or malignant tissues of individuals with Lynch syndrome that researchers hope will stimulate a robust immune-system attack that stops cancer progression at its origin.

In comparison, the Tri-Ad5 vaccines, developed through the National Cancer Institute’s (NCI’s) intramural program, rely on three tumor-associated antigens that are overexpressed in cancer cells, but are also found to a lesser degree in healthy tissues. Because early studies suggested that the approach with only the MUC-1 antigen showed promise, investigators added two other antigens (CEA and brachyury) in the Tri-Ad5 vaccines, which will be combined with an Interleukin-15 (IL-15) “superagonist,” a vaccine stimulant, to increase the vaccine’s potential for destroying premalignant lesions or early tumors.

 “Right now, we are focused on helping high-risk populations, and they, in turn, are teaching us how to develop better cancer preventive vaccines for the future.


Gimme Shelter from Lynch Syndrome

“There is much to be optimistic about right now for those with Lynch. Many medical discoveries and advances have been made within the past decade. Aspirin is used as a chemoprevention, immunotherapy may put various Lynch syndrome-related cancer in remission, and AI is improving screening measures, specifically for colonoscopies. What excites me the most is the Lynch vaccine in clinical trials now. The Lynch landscape has changed since my diagnosis 12 years ago.”


Cancer Trials Ireland

Questions for your doctor

f you would like to know more about whether there is a cancer trial suitable for you,  the first thing you do is to talk to your doctor and/or the cancer trials research team in your hospital.

Here are some questions you may have.

Finding a study / trial

  • Are there any studies or trials I could enter with my type and stage of cancer?

Details about a trial

  • Can you tell me why this study/trial is being done?
  • What is being tested and why?
  • What are the possible advantages and risks of taking part?
  • Is there a chance I will not get the treatment being tested?
  • Will I be allocated a treatment by computer, or do you and I have any choice?
  • How long will the study last?
  • What will I have to do if I take part?
  • Will I have to have extra tests or scans?
  • Will I need to go to hospital?
  • Will I need to take time off work?
  • Will being involved affect my day-to-day life?
  • Who will oversee my cancer care while I am participating – will I have a different doctor?
  • How will I find out about the results if I take part?
  • Can I take part in more than one trial?
  • If I join this trial could I miss out on trials in the future?
  • How long do I have to decide?

How they are run

  • Can I tape the meeting or take notes?
  • Is the study / trial approved?
  • Can I bring a relative or friend to the informed consent meeting?
  • Who will be allowed to see my medical records?
  • What information about me will be on the computer?
  • Who will be told I am in a trial?
  • Can I claim expenses, such as travelling costs?


  • Who can I contact if I have a problem?
  • What are the likely side effects?
  • Can I leave the trial if I want to?
  • What will happen if I get side effects?
  • Who can I contact in an emergency?
  • Who makes sure the trial is safe and properly run?
  • Am I covered by insurance if things go wrong?
  • Is there anything I am not allowed to do while I am in the trial?
  • Are there any drugs or medicines I shouldn’t take while I am in the trial?
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