Wolchok J D, Livingston P O
Clinical Immunology Service, Hematologic Department of Medicine, Memorial Sloan-Kettering Cancer Center, NY 10021, USA.
Lancet Oncol. 2001 Apr;2(4):205-11. doi: 10.1016/s1470-2045(00)00290-4.
Advances in molecular biology and immunology in the past 10-15 years have allowed for a greater understanding of the molecules present on melanoma cells that are recognised by the immune system. The rising incidence of melanoma, combined with lack of efficacy of cytotoxic therapies, means there is a significant need for the development of effective immunotherapies. We discuss three types of vaccine for melanoma, which are currently in phase III clinical trials: allogeneic and autologous cellular vaccines, and carbohydrate vaccines. We also discuss several new areas of vaccine development, including DNA vaccines, dendritic-cell-based vaccines, peptide vaccines, and heat-shock protein vaccines. Although initial clinical trials have shown the safety and immunological efficacy of vaccines for melanoma, the true clinical benefit of these strategies will only be revealed in large randomised trials.
过去10到15年里,分子生物学和免疫学的进展使人们对黑色素瘤细胞上可被免疫系统识别的分子有了更深入的了解。黑色素瘤发病率不断上升,加上细胞毒性疗法效果不佳,这意味着迫切需要开发有效的免疫疗法。我们讨论了目前正处于III期临床试验的三种黑色素瘤疫苗:同种异体和自体细胞疫苗以及碳水化合物疫苗。我们还讨论了疫苗研发的几个新领域,包括DNA疫苗、基于树突状细胞的疫苗、肽疫苗和热休克蛋白疫苗。尽管初步临床试验已显示黑色素瘤疫苗的安全性和免疫疗效,但这些策略的真正临床益处只有在大型随机试验中才能显现出来。