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Arthur M. Krieg
Published in Volume 117, Issue 5
J Clin Invest. 2007; 117(5):1184–1194 doi:10.1172/JCI31414
Abstract | Full text | PDF
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Figure 3
Potential mechanism to explain the observed antitumor synergy of TLR9 with chemotherapy.

Tumor antigens are constitutively present in cancer patients and are taken up by DCs in the tumor and secondary lymphoid organs. In patients with established tumors, the immune system fails to respond to the tumor antigens due to the tumor-induced Tregs and other immune-suppressive effects. Certain chemotherapy regimens effectively deplete Tregs and also disrupt the tumor, releasing additional antigen and interfering with the ability of the tumor and its mesenchymal support structures to suppress the immune system. When such chemotherapy is followed by treatment with a TLR9 agonist (CpG ODN), DCs bearing tumor antigens are stimulated to mature and become effective inducers of a CTL response, which in the postchemotherapy environment is now better able to attack the tumor, leading to improved survival.