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Liao et al. J Cancer Metastasis Treat 2018;4:3 Journal of Cancer
DOI: 10.20517/2394-4722.2017.63 Metastasis and Treatment

Commentary Open Access

Immunotherapy of cancer is a part of biotherapy

Shuen-Kuei Liao , Robert K. Oldham 3
1,2
1 The PhD Program for Cancer Biology and Drug Discovery, Taipei Medical University, Taipei City 11031, Taiwan, China.
2 Vectorite Biomedical Inc., New Taipei City 22175, Taiwan, China.
3 Hope Regional Cancer Center, Panama, FL 32444, USA.

Correspondence to: Prof. Shuen-Kuei Liao, The PhD Program for Cancer Biology and Drug Discovery, Taipei Medical University, Taipei
City 11031, Taiwan, China. E-mail: liaosk@h.tmu.edu.tw

How to cite this article: Liao SK, Oldham RK. Immunotherapy of cancer is a part of biotherapy. J Cancer Metastasis Treat 2018;4:3.
http://dx.doi.org/10.20517/2394-4722.2017.63
Received: 2 Oct 2017 First Decision: 2 Jan 2018 Revised: 8 Jan 2018 Accepted: 12 Jan 2018 Published: 22 Jan 2018

Science Editor: Lucio Miele Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

INTRODUCTION
The terms immunotherapy of cancer and biotherapy of cancer have been used interchangeably in the
past. Strictly speaking, biotherapy or biological therapy is more appropriate and is now considered the
4th modality of cancer therapy. It can be effective when used alone or in combination with surgery,
radiation or chemotherapy. To put biotherapy into a better perspective, it is important to clarify a historical
misconception associated with immunotherapy. The term biological response modifiers (BRMs), which had
been widely used in the 1970s, referred to agents or approaches, whose modes of action involve the host’s
own biological responses. Biological substances and BRMs work through many different mechanisms in
the biotherapy of cancer. These mechanisms involved for each substance/modifier may be one or several
of the following: (1) to increase the host’s antitumor response through augmentation or restoration of
effector mechanisms or decrease a component of the host response that is deleterious (such as with immune
[1]
checkpoint inhibitors, e.g. anti-CTLA-4) ; (2) to augment host defenses through the administration of
certain immune cells, natural biological substances, or synthetic derivatives thereof as effectors (direct or
indirect) of antitumor responses; (3) to enhance the host responses using modified tumor cells or other types
of vaccines to stimulate greater immune responses or increase the sensitivity of tumor cells in vivo; (4) to
increase the maturation, differentiation or dormancy of tumor cells; (5) to interfere with growth-promoting
factors or signaling pathways of tumor cells concerning proliferation, migration/invasion, apoptosis, and
angiogenesis; (6) to use biological molecules to target and bind to cancer cells or immune cells to induce
greater effective cytostatic/cytotoxic antitumor activity; and (7) to use biological molecules to modify the
tumor microenvironment or the host immune system such as allowing effector T cells or natural killer
(NK) cells to effectively target and eradicate tumor cells. Thus, one can envisage biotherapy with immune

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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