Review Article

Immunotherapy: Newer Therapeutic Armamentarium against Cancer Stem Cells

Table 3

CSC-targeting strategies and their effect in different types of cancer.

TypeCancer typesEffects of the CSC-targeting strategiesReference

CSC-primed T cellsHead and neckALDH1A1-specific CD8+ T cells distinguish and eradicate ALDHhi CSCs in in vitro bioassays, retard xenograft growth and metastases in in vivo bioassays, and prolong survival[105]
LungALDHhigh-CD8+ T cells resulted in the inhibition of tumor growth and prolonged survival, hence, bestowing more considerable antitumor effects[106]

CSC-lysate DC vaccineSquamous cell Carcinoma/MelanomaCSC-DC vaccine that was administered in the adjuvant setting after localized radiation therapy of established tumors resulted in a reduction of tumor growth, and vaccination significantly inhibited tumor growth, abridged ALDHhigh CSC frequency in primary tumors, and metastases through stimulation of humoral immune responses against CSCs[123]
SCC growth was regressed compared to immunization with bulk tumor cells and lung metastasis of melanoma cells was appreciably curtailed[51]
In the adjuvant setting, simultaneous PD-L1 blockade further enhanced local tumor recurrence and spontaneous pulmonary metastasis and also increased survival of the host[125]
ProstateTumor regression was witnessed in TRAMP mice, tumor growth was delayed in mice challenged with prostate CSCs, and tumor-specific immune response was induced that was stronger than differentiated tumor cells[121]
GlioblastomasAntigen-specific T-cell responses against CSCs were elicited and survival in animals was improved[120]
BreastMigration of DCs to the spleen activated CD8+ and CD45+ T cells; in turn, CTL antitumor responses were induced[122]

CSC-mRNA-DC vaccineGlioblastomasSeven patients vaccinated with an mRNA-DC vaccine exhibited a common immune response[172]

DNA vaccineRenal cell carcinomaStronger antitumor effects were observed in immunization with DNAJB8 expression plasmids in contrast with immunization with the tumor-associated antigen survivin, which was expressed in both CSCs and non-CSCs[128]

NK cellsGlioblastomasNeural stem cells derived from tumor specimens were prone to attack by lysis mediated by both autologous IL-2 (or IL-15) activated NK cells but resisted freshly isolated NK cells[95]
Pancreatic/Breast/GlioblastomasCSCs isolated from an array of human cancer cell lines in vitro and dissociated primary cancer specimens ex vivo were preferentially targeted by allogenic activated human NK cells[173]

mAbLiver/PancreaticThe growth of hepatic and pancreatic cancer cells was inhibited in vitro and in vivo and CD133 high CSCs were targeted by CIK cells bound with anti-CD133/anti-CD3 bispecific antibodies[137]
MelanomaHuman melanoma metastasis was inhibited and the survival of tumor-bearing animals was prolonged by anti-CD44 antibodies[133]
BreastMurine breast tumor growth was inhibited and apoptosis was induced by anti-CD44 antibodies[134]

CSC-CAR TGlioblastomasPatient-derived GBM CSCs were annihilated in an orthotopic tumor model and in vitro by anti-CD133 CAR T cells[112]
ProstateSignificant antitumor efficacy was exhibited by EpCAM-specific CAR T cells in vitro and in vivo systems[113]