Introduction

Cancer immunotherapy is a promising treatment for cancer that aims to provide treatment more accurately and safely than other traditional therapies [1, 2]. Agents are designed to provoke a robust primary and secondary antitumor immune response by repairing or enhancing natural mechanisms that are evaded or damaged during disease progression, thus inhibiting tumor growth and metastasis [3,4,5].

Approximately a century ago, Coley first used a method to activate the patient’s immune system to help treat tumors [6]. In the immune system, antigen-presenting cells (APCs) continuously eliminate exogenous or endogenous antigens; antigens are taken up and processed to be exposed onto major histocompatibility complexes (MHCs) I or II on the APC surface for further presentation to naive T cells [7, 8]. The three main pathways by which APCs activate T cells are the binding of MHC complexes to T-cell receptors, the presence of costimulatory molecules on the cell surface (CD80 and 86 on APCs binding to CD28 on T cells) and the cytokines that stimulate T cells [9]. T cells can differentiate into two major subpopulations: CD4+ T cells, which can further differentiate into T-helper 1 (Th1) and T-helper 2 (Th2) cells, and CD8+ T cells, which can further differentiate into cytotoxic T lymphocytes (CTLs) to directly kill tumor cells [9, 10]. Both CD8+ T cells and IFN-γ-secreting Th1 CD4+ T cells play a vital role in killing tumors [10, 11] (Fig. 1).

Fig. 1
figure 1

Scheme of the cancer immunotherapy mechanism. After antigens are processed by immature dendritic cells (ImDCs), they are presented to T cells by mature dendritic cells (mDCs) through major histocompatibility complex (MHC) class I or MHC class II complexes binding to CD8+ or CD4+ T cells, separately. Simultaneously, mDCs also express costimulatory molecules and cytokines such as IFN-γ and IL-12 to synergistically stimulate T cells. CD8+ T cells further differentiate into cytotoxic T lymphocytes (CTLs), and CD4+ T cells further differentiate into IFN-γ secreting T-helper 1 (Th1) cells to assist in activating CD8 cells and other innate immune cells, such as natural killer (NK) cells, granulocytes or macrophages, to directly kill tumor cells

In 1986, the US Food and Drug Administration (FDA) approved recombinant versions of the cytokine interferon-α (IFN-α) as the first cancer immunotherapeutic drug for the treatment of hairy cell leukemia; however, IFN-α was replaced because of its short therapeutic duration [12]. Subsequently, recombinant interleukin-2 (IL-2) was approved by the FDA as a cancer immunotherapy drug for the treatment of metastatic renal cancer (in 1992) and metastatic melanoma (in 1998), separately [13]. Although IL-2 initially has a good therapeutic effect in some patients, the use of large doses due to its short half-life results in many immune-related side effects, such as cytokine release syndrome and vascular leakage syndrome [14,15,16]. After a stagnant phase, sipuleucel-T (an autologous dendritic cell (DC) therapy) as the first cancer therapeutic vaccine was approved by the FDA for prostate cancer, which meant tumor immunotherapy had finally made successful progress in the early 21st century. However, production complexities and other issues hindered the clinical translation of sipuleucel-T [17, 18]. Since the cytotoxic T-lymphocyte antigen-4 (CTLA-4)-targeted checkpoint inhibitor ipilimumab was approved for advanced melanoma in 2011 [19], there has been a shift towards novel immunotherapies, including programmed cell death-1 or its ligand monoclonal antibody (aPD1 or aPDL1) [20] and chimeric antigen receptor (CAR) T-cell therapies [21,22,23].

Although these treatments have been developed and approved for clinical use and have achieved some efficacy, many problems regarding safety and effectiveness remain to be solved [14, 24, 25]. In terms of safety, some immunotherapeutic drugs require a large dose for their short half-life, which causes autoimmune side effects in some patients. For example, two syndromes (cytokine release syndrome and vascular leakage syndrome) caused by IL-2 lead to severe and even lethal systemic inflammatory reactions in some patients [25]. In terms of efficacy, current immunotherapy is only effective in some patients, and most immunotherapy is initially used only to treat hematological tumors. Only a few immunotherapies for the treatment of solid tumors are approved because solid tumors have a complex tumor microenvironment (TME) that is a difficult barrier to break through [26].

To reduce side effects and improve the accuracy of immunotherapy, novel delivery systems need to be manufactured. In recent years, with the development of nanotechnology, an increasing number of delivery systems have been designed for the local and sustained release of immunotherapeutic drugs in vivo [27,28,29]. Biomaterial-based delivery systems have many advantages in cancer immunotherapy, such as the specific and targeted delivery of biomolecules, high efficacy, low toxicity, and immune-stimulating effects (Table 1) [27, 30, 31]. A great variety of advanced biomaterials can be used for cancer immunotherapy, including liposomes, polymers, silica, and so on (Fig. 2) [2, 32, 33]. Different biomaterials use various means and technologies to play an important role in cancer prevention [34,35,36,37,38]. To achieve precise antitumor effects, these advanced biomaterials with different functions can be used to deliver immunopharmaceuticals to organs or tissues (such as the mucosa or skin) that are rich in immune cells by different routes of administration (for instance, intranasally [39], orally [40], and subcutaneously [84]. However, naked RNA is highly susceptible to degradation by nucleases; therefore, it requires special transfection reagents or delivery techniques to enhance its intracellular delivery [85]. Thus, nucleic acid vaccines can greatly benefit from advanced delivery technologies and materials, which are technical barriers to current nucleic acid vaccines. An effective and safe delivery system is the key to the successful application of nucleic acid vaccines.

Neoantigen vaccines use tumor somatic DNA as antigens to promote the antitumor immune response [86]. These antigens are only expressed in tumor cells and can avoid damage to normal tissues [87]. Advanced materials and delivery systems can improve the stability of these neoantigens and combine multiple vaccine classes to improve the safety and efficacy of cancer vaccines [88,159].

PLGA-based microspheres were found to enable the eradication of prostate carcinoma by codelivering tumor lysates, CpG-ODN, and Poly(I:C), and their capacity to stimulate T cells to produce IFN-γ and granzyme B was significantly enhanced in TRAMP mice [160]. PLGA polymers were also used to codeliver OVA, CpG-ODN, and Poly(I:C); however, the therapeutic effects were weakened, and the production of IFN-γ and the activation of DCs were decreased under chronic stress [161]. Two TLR7/8 agonists have been synthesized and encapsulated in PLGA NPs. This OVA or tumor lysate NP vaccine significantly inhibits tumor growth in B16F10-OVA or renal cell carcinoma by stimulating the CD8+ CTL response [162].

To realize image-guided delivery of immunomodulators, IFN-γ and iron oxide nanocubes were coencapsulated in PLGA microspheres. This delivery system could provide a convenient way of delivering drugs to tumor sites after injection and monitoring the distribution of drugs sequentially [163]. A new combination method that uses PLGA for encapsulating a physical mixture of ovalbumin and hydroxychloroquine promotes CD8+ CTL and memory T-cell immune responses in tumor tissues via the controlled release of OVA and upregulation of MHC-I and CD86 costimulatory molecules in DCs [164]. To achieve the goal of targeting DCs more accurately, Rosalia et al. designed a PLGA-based CD-40-targeted cancer vaccine that showed significant enhancements in delaying tumor growth and extending the survival of tumor-bearing mice by facilitating antigen-specific antitumor CD8+ T-cell responses [165]. Recently, combination immunotherapy has become a particularly promising strategy for tumor treatment, and PLGA has been used to realize the codelivery of antiprogrammed cell death-1 (aPD1) and T-cell agonist (aOX40) agents to simultaneously rather than sequentially elicit the activation of T cells. These dual-immunotherapy NPs increased the ratio of CD8+ to regulatory T cells infiltrating the tumor, thereby promoting therapeutic efficacy in both B16F10 melanoma tumors and 4T1 breast cancers [166].

Indocyanine green (ICG) and imiquimod (R837) were coloaded by PLGA to achieve the eradication of preexisting tumors and enhance the antitumor immune response simultaneously. Moreover, with the combination of these particles and anti-CTLA-4, this strategy has been proven to delay tumor growth and extend survival in both 4T1 and CT26 tumor models [167]. PLGA polymers as biodegradable materials can also be combined with photothermal agents. Researchers produced anti-PD-1 peptide (AUNP12) and hollow gold nanoshell coencapsulated PLGA NPs, and these particles facilitated the effective inhibition of primary and distal tumor growth via an increasing percentage of CD8+ CTLs and secretion of IFN-γ [168]. In addition, the coadministration of anti-PD-1 peptide (AUNP12) and hollow gold nanoshell coencapsulated PLGA NPs with CpG has been proven to mediate the maturation of DCs in vitro and enable direct tumor necrosis in bilateral and lung metastatic 4T1 tumor-bearing mice [169]. The antibody-modified PLGA core was used to load the hydrophobic drug imatinib (IMT), which was developed as an inhibitor of tyrosine kinase and then manufactured as IR-780 and IMT codelivery PH-sensitive NPs, which showed a great capacity to stimulate an effective CD8+ T-cell antitumor immune response [170].

Researchers have compared the capacity of synthetic long peptide-based cationic liposomes and PLGA NPs to induce an immune response. They proved that liposomes have advantages over PLGA particles for inducing the T-cell response. However, the mechanism of this phenomenon has not been investigated [171]. In addition, PLGA polymers used to formulate antigen-capturing nanoparticles (AC-NPs) were proven to promote an antitumor immune response and improve the efficacy of αPD-1 immunotherapy. The surfaces of PLGA NPs were modified by different chemical groups to bind tumor antigens; however, although all other AC-NPs except mPEG AC-NPs loaded plenty of proteins, PLGA and Mal AC-NPs showed a higher ability to improve the immunotherapeutic efficacy (Fig. 4) [172].

Fig. 4
figure 4

AC-NPs have the capacity to inhibit distant B16F10 xenografts. a Schematic illustration of cancer immunotherapy promotion by using antigen-capturing nanoparticles (AC-NPs) combined with radiotherapy and αPD-1 treatment. b Average tumor growth curves of abscopal tumors in mice treated with different administrations. c The survival rate of the treated mice in b. Reprinted with permission from [172]

Hydrogels

Hydrogels can serve as antigen storage caverns because of their gelation properties, and they have been used as vectors to coload cytokines, proteins, DNAs, and so on [31, 173,174,175,176,177,178,179]. Alginate microparticle-based injectable gels were reported ~10 years ago and have been used to codeliver mature DCs and chemokines CCL21 and CCL19. The study showed that this hydrogel system could recruit host DCs to the injection site and migrate to local lymph nodes at the same time, thus providing a continual process to initiate the immune response [180]. Researchers have designed a two-step strategy to realize the recruitment of APCs and presentation of antigens via the injection of GM-CSF delivering mPEG−PLGA hydrogels followed by the administration of antigen-loaded vectors, which showed obvious antitumor immunotherapeutic potential [181]. Nanogel particles formed by cholesteryl pullulan showed the good function of delivering and cross-presenting antigens to medullary macrophages. In addition, the study revealed that this vaccine could significantly slow tumor growth with the help of Toll-like receptor agonists [182].

Hyaluronic acid–tyramine-based hydrogels have been used to deliver IFN-α to the injection site and to inhibit tumor proliferation via the coadministration of sorafenib [183]. In addition, a hyaluronic acid-pluronic F-127 hydrogel was used to prepare black phosphorus quantum dot nanovesicles (BPQD-CCNVs), GM-CSF, and LPS coloaded systems. The study showed that the sustained release of GM-CSF and LPS from the injection site could recruit and activate DCs. In addition, NIR irradiation combined with PD-1 antibody could generate a strong antitumor immune response [184].

Mooney and his colleagues manufactured an infection-mimicking system to coload GM-CSF, Toll-like receptor agonists (CpG-ODN) and a tumor lysate to achieve the recruitment and activation of DCs, which promoted a specific and effective antitumor immune response [185, 186]. The same team designed a cryogel-based delivery system to encapsulate GM-CSF and CpG-ODN. This vaccine could be subcutaneously injected into mice and controlled release immunomodulatory factors and cancer antigens, thus provoking strong antitumor T-cell responses and improving the survival rate of B16F10-bearing mice [187].

Yang and coworkers reported that hydrogels formed by phosphatase enzymes had good potency in evoking humoral and cellular immune responses and could be used as protein vaccine adjuvants [188]. Moreover, they also proved that peptide Nap-GFFY hydrogels formed by a very simple process could also provoke a cogent CD8+ T-cell immune response [189]. Chao et al. designed a combination system in which ALG was cross-linked by multivalent cations and 131I-labeled catalase coadministered and jellified in a local tumor site, followed by systemic CTLA-4 injection. This strategy delayed local tumor growth and metastasis [190].

Gu and coworkers designed a therapeutic scaffold formed by a ROS-responsive hydrogel to release gemcitabine (GEM) and an anti-PD-L1 blocking antibody (aPDL1) locally in tumor-bearing mice [191]. This system significantly decreased the level of ROS and the numbers of myeloid-derived suppressor cells and TAMs in the tumor site. Moreover, a 50% survival rate and 30% recurrence rate were observed in the aPDL1-GEM@Gel treatment group on account of primary and memory immune responses. In the same year, this research group also generated another immunotherapeutic gel for postsurgical tumor treatment, which was manufactured by mixing the fibrinogen solution containing anti-CD47 antibody-loaded CaCO3 NPs and thrombin solution in the postsurgical tumor site [192]. This strategy had the potency of preventing local and distant tumors via activating M1-type TAMs and promoting macrophage phagocytosis and antitumor immune responses.

DNA-based supramolecular hydrogels were reported to recruit and activate APCs by releasing a high concentration of CpG, which could serve as a promising method for tumor immunotherapy [193]. Song et al. demonstrated a poly(L-valine) hydrogel for coencapsulating TCL, TLR3 agonist, poly(I:C) that realizes the controlled release of antigens and adjuvants, thus promoting antigen persistence and presentation to enhance the cytotoxic T-lymphocyte immune response against cancer [194]. A tumor-penetrable peptide-based hydrogel was prepared by encapsulating JQ-1 (a BRD4 inhibitor) and ICG coloaded tumor cells (Fig. 5) [195]. This vaccine could evoke a strong patient-specific immune response and prevent recurrence and metastasis of postsurgical tumors by NIR laser-triggered release of tumor-specific antigens and JQ-1.

Fig. 5
figure 5

PVAX immunotherapy for both recurrent and metastatic 4T1 tumors. a Schematic depiction of the manufacture of PVAX for cancer immunotherapy. b Average and individual tumor growth curves of recurrent 4T1 xenografts in mice treated with different formulations. c Survival curves of the mice bearing 4T1 recurrent tumors. d Average tumor growth curves of the distant tumors treated with different formulations. e Tumor-free percentages of the abscopal tumor. Reprinted with permission from [195]

Inorganic biomaterials

Siliceous nanoparticles

Mesoporous silica NPs can be prepared by using organosilane precursors to participate in hydrolysis and condensation reactions [196, 197]. Moreover, the surface of these particles can be modified with various reactive groups for different medical applications [198, 199]. Amino acid-modified silica NPs were reported to promote cytokine production, and silica nanospheres doped with Ca, Mg, and Zn (MS-Ca, MS-Mg, and MS-Zn) showed the capacity to provoke a Th1 anticancer immune response [200, 201]. Both spherical silica NPs and asymmetric mesoporous silica NPs were found to have the potential to activate and mature immune cells [202,203,204,205,206]. In addition, siliceous NPs also play a strong role in vaccine formulations such as the Japanese encephalitis vaccine [207], hepatitis B virus DNA vaccine [208], and oral hepatitis B vaccine [209], as well as in viral vaccine heat resistance [210] and viral inhibition [211]. Mesoporous silica-templated and hollow particles were designed to load antigens and adjuvants that showed a robust lymph node targeting and immune cell-activating capacity [212,213,214,215,216]. Yang et al. achieved the synthesis of dendritic mesoporous organosilica hollow spheres for the first time, which showed a significant potential to provoke an antitumor immune response [217]. Mooney and coworkers reported mesoporous silica rods (MSRs) with a high aspect ratio that spontaneously assembled as a macroporous structure to recruit DCs and generate humoral and cellular immune responses against tumors in the presence of GM-CSF and CpG [218]. They also modified these MSRs with PEG, PEG–RGD, or PEG–RDG groups [219] and PEI (Fig. 6) [220], which promoted immune cell activation and infiltration and may pave the way for cancer vaccination.

Fig. 6
figure 6

The MSR–PEI vaccine inhibits established tumors. a Schematic illustration of PEI and antigen adsorption. b Schematic depiction of the MSR vaccine and MSR–PEI vaccine. Tumor growth (c) and survival rate (d) of mice bearing E7-expressing TC-1 tumors rechallenged with TC-1 cells. e The survival rate of mice bearing E7-expressing TC-1 tumors treated with different formulations. Reprinted with permission from [220]

Iron oxide nanoparticles

Because iron oxide NPs have been approved for human use as MRI contrast agents and their degradation products are good for the body’s iron store, iron oxide NPs have been increasingly used simultaneously for cancer immunotherapy and imaging [221,222,223]. Iron oxide NPs can be modified with many cargos to improve the antitumor immune response, such as heat shock protein 70 (Hsp70) [224], R837 and Poly(I:C) [225], CpG-ODN [226], and ICG [227]. These NPs have the potential to realize the integration of imaging and therapy.

Gold nanoparticles

Photothermal immunotherapy is an effective treatment combining laser photophysical effects with immunoregulation [228,229,230]. Many photothermal biomaterials, such as gold nanorods [231], Prussian blue [232, 233], and NIR photosensitizers [234], have recently been used for cancer immunotherapy. Gold NP labeled melanoma-specific T cells show the potential to be noninvasively imaged by classical X-ray computed tomography, which provides a convenient way to track immune cells in immunotherapy [235]. More interestingly, gold NPs can predict the therapeutic response to immune checkpoint blockade after modification with programmed death-ligand 1 antibody (αPD-L1) [236]. Gold-based NPs may also be combined with adjuvants to promote antitumor immune responses and contribute to cancer immunotherapy [237, 238].

Others

Microneedles with dimensions of <1 mm can be utilized to pierce the skin to the dermis in a minimally invasive and painless manner [239,240,241]. As a significant research target, microneedles have been used in many aspects, such as the delivery of small molecule and protein drugs and vaccines [242,243,244]. It is an inexpensive and convenient way to use microneedles for various medical applications [245,246,247,248,249]. There are many lymph nodes in the dermis; thus, microneedles achieve direct contact with DCs for antigen uptake and presentation [27]. To decrease the cost of treatment and reduce the dosage-dependent side effect [250,251,252] of immunomodulators, Gu and coworkers prepared biocompatible hyaluronic acid (HA)-based microneedles integrated with pH-sensitive dextran NPs containing aPD1 and glucose oxidase, which realized the substantial release of aPD1 and evoked a strong immune response in B16F10-bearing mice [253]. Meanwhile, the same group designed another microneedle system that combined aPD1 and 1-methyl-DL-tryptophan (1-MT), an inhibitor of IDO, to promote T-cell immunity and reduce immunosuppression [254]. Moreover, a hyaluronic acid-based MN encapsulated B16F10 melanoma whole tumor lysate and GM-CSF were proven to stimulate a robust antitumor immune response through spatiotemporal PTT and immunotherapy (Fig. 7) [255]. In addition to soluble microneedles, hollow microneedles can also be used for vaccine delivery and immunotherapy on account of the controllability and accuracy of the injection progress [256, 257]. Researchers compared four types of NP-loaded OVA and poly(I:C) by using hollow microneedles, which showed that PLGA NPs and liposomes could provoke stronger IgG2a responses [258]. In addition, a digitally controlled hollow microneedle system was used for the injection of liposomes containing an HPV E743–63 synthetic long peptide, thus reducing pain and the dosage of injection [259].

Fig. 7
figure 7

Local immunotherapy for various tumors via microneedles. a Schematic illustration of immunotherapy utilizing microneedles. b Average tumor growth and survival rate of treated C57BL/6J mice in the BP tumor model. c Average tumor growth and survival rate of treated BALB/c mice in the 4T1 tumor model. d Average tumor growth and survival rate of C57BL/6J mice in established BP tumor models. e Average tumor growth and survival rate of BALB/c mice in established 4T1 tumor models. Reprinted with permission from [255]

In recent years, biologically derived nanobiomaterials, such as cancer cell membranes, viral proteins, and DNAs, have started to be used for new cancer nanovaccines [260,261,262,263]. Researchers found that tumor antigens and subcellular particles in the cancer membrane, such as melanoma cells, could be loaded into various NPs, which induce specific cellular and humoral responses, thus preventing tumor growth [157, 264, 265]. Another approach is to form virus-like NPs via the self-assembly of viral proteins [266]. Furthermore, cowpea mosaic virus NPs effectively evoked cytokine secretion and inhibited tumor growth in various models (Fig. 8) [267].

Fig. 8
figure 8

eCPMV immunotherapy for metastatic breast, colon, and ovarian tumors. a Photo and survival rate of mice in a metastatic breast tumor model. b Photo and survival rate of mice in a colon tumor model. c Photo and survival rate of mice with ID8-Defb29/Vegf-A ovarian cancer. Reprinted with permission from [267]

Conclusion

In this review, we have analyzed different strategies of immunotherapy and described advanced biomaterials that may be applied to improve therapeutic potency and reduce adverse effects. Although cancer immunotherapy is advancing at a high speed, the use of biomaterials to manufacture optimal systems for various tumors remains in its nascent stages. It is hoped that the biomaterials described in this review can be more widely and innovatively designed for cancer immunotherapy, thus promoting its efficacy and reducing immune-related side effects. Although preliminary advances have been made in the design of immunotherapy strategies based on biomaterials, many systems, including NPs, micelles, and hydrogels, can be loaded with multiple drugs and selected based on the targets identified in the patient’s biopsy sample. This personalized treatment will be an important and promising research direction in the future.