Clinical results of vaccine therapy for cancer: learning from history for improving the future.
Active, specific immunotherapy for cancer holds the potential of providing an approach for treating cancers, which have not been controlled by conventional therapy, with very little or no associated toxicity. Despite advances in the understanding of the immunological basis of cancer vaccine therapy as well as technological progress, clinical effectiveness of this therapy has often been frustratingly unpredictable. Hundreds of preclinical and clinical studies have been performed addressing issues related to the generation of a therapeutic immune response against tumors and exploring a diverse array of antigens, immunological adjuvants, and delivery systems for vaccinating patients against cancer. In this chapter, we have summarized a number of clinical trials performed in various cancers with focus on the clinical outcome of vaccination therapy. We have also attempted to draw objective inferences from the published data that may influence the clinical effectiveness of vaccination approaches against cancer. Collectively the data indicate that vaccine therapy is safe, and no significant autoimmune reactions are observed even on long term follow-up. The design of clinical trials have not yet been optimized, but meaningful clinical effects have been seen in B-cell malignancies, lung, prostate, colorectal cancer, and melanoma. It is also obvious that patients with limited disease or in the adjuvant settings have benefited most from this targeted therapy approach. It is imperative that future studies focus on exploring the relationship between immune and clinical responses to establish whether immune monitoring could be a reliable surrogate marker for evaluating the clinical efficacy of cancer vaccines.
Choudhury
Aniruddha
A
Department of Oncology, Cancer Centre Karolinska, Karolinska University, Hospital Solna, SE-171 76 Stockholm, Sweden.
Mosolits
Szilvia
S
Kokhaei
Parviz
P
Hansson
Lotta
L
Palma
Marzia
M
Mellstedt
Håkan
H
D000951:Antigens, Neoplasm / Q000378:metabolism; D019496:Cancer Vaccines / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D009369:Neoplasms / Q000517:prevention & control* / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014611:Vaccination / Q000379:methods / Q000639:trends
D000951:Antigens, Neoplasm; D019496:Cancer Vaccines