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. Author manuscript; available in PMC: 2016 Jan 31.
Published in final edited form as: Ther Deliv. 2015 Apr;6(4):453–468. doi: 10.4155/tde.14.123

Figure 1. Immunological and genetic effects of chemotherapy.

Figure 1

(A) Effects of the chemotherapeutic agents temozolomide, cyclophosphamide, cisplatin and 5-FU on the local tumor environment. Depletion of Tregs and MDSCs allows infiltration of CD4+ and CD8+ effector T cells. (B) Cytotoxic effects of chemotherapeutic agents. TMZ and CPA induce intra- and interstrand DNA cross-links. Etoposide allows for accumulation of double stranded DNA breaks. Rapamycin and other inhibitors of the PI3K/Akt/mTOR pathway decrease DNA replication and cell proliferation. 5-FU inhibits thymidylate synthase and uracil is incorporated into DNA instead of thymidine, inhibiting DNA synthesis.

5-FU: 5-Fluorouracil; CPA: Cyclophosphamide; MDSC: Myeloid derived suppressor cells; mTOR: Mammalian target of rapamycin; PI3K: Phosphatidylinositol 3-kinase; TMZ: Temozolomide.