From genomics to cancer vaccines: patient-tailored or universal vaccines?

There is little doubt about the existence of tumor-associated antigens and T-cell-mediated immune responses against cancer antigens. Antitumor immunity has been identified in many patients with very different types of cancer. Nevertheless, there is still no consensus regarding the correct targets to be used for cancer immunotherapy, including cancer vaccines and adoptive T-cell transfer of tumor antigen-specific T-cells. Certainly, functional genomics and proteomics will have implications on the field of tumor antigen discovery due to the possibility of molecular characterization of whole transcriptomes and proteomes of cancer cells, thereby also identifying potential new targets for cancer immunotherapy. Based on fundamental immunological knowledge, it is hypothesized that the most promising approach would be patient-tailored. Alternatively, if genes are identified in the majority of all cancers, a more universal approach to cancer vaccines can be envisioned. Success with these opposing strategies will greatly rely on whether it is possible to induce robust immunity against the antigens identified, whether technical and regulatory issues of patient-tailored approaches can be adequately addressed, and certainly also which approach will be economically more advantageous.