European Institute of Oncology, Department of Medicine, Division of Medical Oncology, Via Ripamonti 435, Milan, Italy.
Breast. 2009 Oct;18 Suppl 3:S51-4. doi: 10.1016/S0960-9776(09)70273-5.
Therapeutic potential of vaccination has been explored in many clinical trials involving patients with breast cancer. A large variety of cancer immunogens have been tested. The majority of clinical vaccination studies have been carried out in patients with metastatic breast cancer, characterized by extremely aggressive malignant tumors, resistant to all standard cytotoxic treatments and with longest-lasting disease. With active specific immunotherapy, tumor-associated antigens coupled to appropriate adjuvant can elicit a powerful antitumor responses. The potential advantages of therapeutic cancer vaccines are that they can augment an established immunogenic response to the tumor (which is generally weak in breast cancer), they target specific tumor antigens (although there are few), they are potentially non-toxic, they can be combined with conventional therapies and/or other immunotherapies, and they elicit immunologic memory to prevent recurrence of the tumor. It is unclear whether therapeutic vaccines for cancer prolong survival. Data of clinical activity have been observed by using vaccines targeting HER-2/neu protein, human telomerase reverse transcriptase, carcinoembryonic antigen (CEA), and carbohydrate antigen given after stem cell rescue. A better understanding of the relation between innate and adaptive immune responses, and of the immune escape mechanisms employed by tumor cells, the discovery of mechanisms underlying immunological tolerance, and acknowledgment of the importance of both cell-mediated and humoral adaptive immunity for the control of tumour growth are necessary for leading to a more comprehensive immunotherapeutic approach in breast cancer.
疫苗接种的治疗潜力已在涉及乳腺癌患者的许多临床试验中得到了探索。已经测试了大量的癌症免疫原。大多数临床疫苗接种研究都是在转移性乳腺癌患者中进行的，这些患者的恶性肿瘤极具侵袭性，对所有标准的细胞毒性治疗均有耐药性，且疾病持续时间最长。通过主动特异性免疫疗法，与适当佐剂偶联的肿瘤相关抗原可以引发强大的抗肿瘤反应。治疗性癌症疫苗的潜在优势在于，它们可以增强对肿瘤的已建立的免疫应答（在乳腺癌中通常较弱），它们针对特定的肿瘤抗原（尽管很少），它们具有潜在的非毒性，可以与常规疗法和/或其他免疫疗法结合使用，并引发免疫记忆以预防肿瘤复发。目前尚不清楚癌症治疗性疫苗是否能延长生存期。通过使用针对 HER-2/neu 蛋白、人端粒酶逆转录酶、癌胚抗原 (CEA) 和糖链抗原的疫苗进行临床观察到了活性数据，这些疫苗是在干细胞挽救后使用的。更深入地了解先天和适应性免疫反应之间的关系，以及肿瘤细胞采用的免疫逃逸机制，发现免疫耐受的机制，并认识到细胞介导和体液适应性免疫对控制肿瘤生长的重要性，对于制定更全面的乳腺癌免疫治疗方法是必要的。
