Vaccines for Ovarian Carcinoma.

BACKGROUND

Metastasis to the abdominal cavity is the primary cause of morbidity and mortality in patients with ovarian cancer. Beyond surgery and chemotherapy combinations, strategies that target tumor cells in vivo are being investigated, such as the use of recombinant cytokines to up-regulate or modulate the cell-mediated or humoral immune response. METHODS: The authors report on their experience with tumor vaccines, including first-generation vaccines, peptide vaccines, and polynucleotide vaccines, in the treatment of ovarian cancer. RESULTS: Cytokines may stimulate proliferation or activation of effector cells that mediate either major histocompatibility restricted cytotoxicity (adaptive immunity) or natural (innate) immunity. Cytokines are often pleiotropic, and their effects may depend on concentration, scheduling, and responsiveness of the cell populations to which they are directed. They also have been used to enhance the efficacy of tumor vaccines that have reached a higher level of sophistication. Recently designed tumor vaccines are capable of stimulating antitumor immune responses that recognize tumor cell epitopes or that have the potential to act synergistically with cytokines such as interleukin-2 and interleukin-12. CONCLUSIONS: Enthusiasm for antitumor vaccine strategies is supported by accumulating clinical reports of responses following treatments using a variety of vaccines. Additional research is needed to determine optimum vaccine approaches for the treatment or prevention of ovarian cancer.