Overview
Cytokines are important mediators of immune responses and produced by almost every cell in the body. Growth stimulatory or inhibitory cytokines could be subclassified as interleukins (ILs), lymphokines, monokines, chemokines, and hematopoietic growth factors. In cancer, certain cytokines act directly on the growth, differentiation, or survival of endothelial cells, whereas others act by attracting inflammatory cell types affecting angiogenesis or by inducing secondary cytokines or other mediators regulating angiogenesis. Proinflammatory and chemotactic cytokines influence the tumor environment and control the quantity and nature of infiltrating hematopoietic effector cells, with inhibiting or enhancing effects on tumor growth. The important role of cytokines in regulating immune responses may permit an effective immune response against the tumors or suppress the function of antigen‐presenting cells (APC).
The understanding of cytokines has now emerged as complex picture of interacting stimulatory and inhibitory factors. Many of the molecules that govern this process have been cloned and have entered clinical trials. It is now clear that regulatory cytokines are characteristically pleiotropic and, at the same time, exhibit significant functional redundancy.
The biologic characterization of the known clinically relevant ILs, interferons and selected growth factors, the rationale for their use in therapy for patients with cancer, and the accumulated clinical experience represent the subjects of this chapter.