Active immunotherapy for non-small-cell lung cancer: moving toward a reality.

Lung cancer remains the number one cause of cancer-related death worldwide. Active cancer immunotherapy is a growing field that is included as one of the most important modalities used to modify the host immune system for the treatment of malignancies. With the recent approval of sipuleucel-T for the treatment of prostate cancer, immunotherapy has become a reality in the treatment of solid tumors. Different therapeutic cancer vaccines, aimed to create specific anti-tumor immunity, are currently under clinical development in non-small-cell lung cancer (NSCLC). Whole-cell vaccines such as belagenpumatucel-L and antigen-specific vaccines targeting EGF, mucin 1 and melanoma-associated antigen A3 have shown promising results in clinical trials and are currently being evaluated in Phase III studies. In Cuba, the CIMAvax vaccine targeting EGF has shown encouraging results, leading to the approval of this therapy there and in other countries in Central and South America. Immunotherapy lacks long term clinical experience as chemotherapy does, however, its lower toxicity promises to be a potential option for the different stages of this disease. The ongoing Phase III trials on the different therapeutic vaccines like the ones targeting melanoma associated antigen-3 and blp-25 in NSCLC will probably be completed within the next few years, and, perhaps, a new era of therapeutic cancer vaccines in NSCLC will be a reality.