Odunsi Kunle, Sabbatini Paul
Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Am J Reprod Immunol. 2008 Jan;59(1):62-74. doi: 10.1111/j.1600-0897.2007.00560.x.
The clinical course of ovarian cancer is often marked by periods of relapse and remission until chemo-resistance develops. Patients in remission with minimal disease burdens are ideally suited for the evaluation of immune-based strategies. Major obstacles to the development of successful immune strategies include the identification of tumor-restricted immunogenic targets, generation of a sufficient immune response to cause tumor rejection, and approaches to overcome evasion of immune attack. Many questions remain as optimal strategies are developed, which include: (i) What is the best antigen form (e.g. peptides, proteins or tumor lysates)? (ii) What are the appropriate adjuvants? (iii) Are mono-valent or multi-valent vaccines likely to be more effective? (iv) What is the optimal frequency and duration of vaccination? (v) How should antigen-specific responses be monitored? and (vi) How should the anti-cancer response be maintained? In this review, we explore representative examples of immune strategies under investigation for patients with ovarian carcinoma which illustrate many of these issues. Basic principles generic to all these immunotherapeutic approaches will also be discussed.
卵巢癌的临床病程通常以复发和缓解期交替为特征，直至出现化疗耐药。疾病负担极小的缓解期患者是评估免疫治疗策略的理想对象。成功开发免疫治疗策略的主要障碍包括识别肿瘤特异性免疫原性靶点、产生足以导致肿瘤排斥的免疫反应，以及克服肿瘤免疫逃逸的方法。随着最佳策略的不断发展，仍存在许多问题，其中包括：（i）最佳抗原形式是什么（例如肽、蛋白质或肿瘤裂解物）？（ii）合适的佐剂有哪些？（iii）单价疫苗还是多价疫苗可能更有效？（iv）疫苗接种的最佳频率和持续时间是多少？（v）应如何监测抗原特异性反应？以及（vi）应如何维持抗癌反应？在本综述中，我们探讨了正在研究的针对卵巢癌患者的免疫治疗策略的代表性实例，这些实例阐明了其中的许多问题。还将讨论所有这些免疫治疗方法共有的基本原则。
