Department of Surgery-Campus Grosshadern, Thoracic Surgery Center Munich, Laboratory of Clinical and Experimental Tumor Immunology, Ludwig-Maximilians-University, Munich, Germany;
J Thorac Dis. 2011 Jun;3(2):105-14. doi: 10.3978/j.issn.2072-1439.2010.12.06.
Non-small cell lung cancer constitutes about 85% of all newly diagnosed cases of lung cancer and continues to be the leading cause of cancer-related deaths worldwide. Standard treatment for this devastating disease, such as systemic chemotherapy, has reached a plateau in effectiveness and comes with considerable toxicities. For all stages of disease fewer than 20% of patients are alive 5 years after diagnosis; for metastatic disease the median survival is less than one year. Until now, the success of active-specific immunotherapy for all tumor types has been sporadic and unpredictable. However, the active-specific stimulation of the host's own immune system still holds great promise for achieving non-toxic and durable antitumor responses. Recently, sipuleucel-T (Provenge(®); Dendreon Corp., Seattle, WA) was the first therapeutic cancer vaccine to receive market approval, in this case for advanced prostate cancer. Other phase III clinical trials using time-dependent endpoints, e.g. in melanoma and follicular lymphoma, have recently turned out positive. More sophisticated specific vaccines have now also been developed for lung cancer, which, for long, was not considered an immune-sensitive malignancy. This may explain why advances in active-specific immunotherapy for lung cancer lag behind similar efforts in renal cell cancer, melanoma or prostate cancer. However, various vaccines are now being evaluated in controlled phase III clinical trials, raising hopes that active-specific immunotherapy may become an additional effective therapy for patients with lung cancer. This article reviews the most prominent active-specific immunotherapeutic approaches using protein/peptide, whole tumor cells, and dendritic cells as vaccines for lung cancer.
非小细胞肺癌约占所有新诊断肺癌病例的 85%，仍然是全球癌症相关死亡的主要原因。这种破坏性疾病的标准治疗方法，如全身化疗，在疗效上已经达到了一个瓶颈，而且伴随着相当大的毒性。对于所有疾病阶段，少于 20%的患者在诊断后 5 年内仍然存活；对于转移性疾病，中位生存期不到一年。到目前为止，针对所有肿瘤类型的主动特异性免疫疗法的成功都是零星的和不可预测的。然而，主动特异性地刺激宿主自身的免疫系统仍然有很大的希望实现无毒和持久的抗肿瘤反应。最近，sipuleucel-T（Provenge®；Dendreon 公司，西雅图，华盛顿州）是第一个获得市场批准的治疗性癌症疫苗，用于治疗晚期前列腺癌。其他使用时间依赖性终点的 III 期临床试验，如黑色素瘤和滤泡性淋巴瘤，最近也取得了积极的结果。现在也为肺癌开发了更复杂的特异性疫苗，而肺癌长期以来并不被认为是一种免疫敏感的恶性肿瘤。这可能解释了为什么肺癌的主动特异性免疫疗法的进展落后于肾细胞癌、黑色素瘤或前列腺癌的类似努力。然而，目前正在对各种疫苗进行对照 III 期临床试验评估，这使得人们希望主动特异性免疫疗法可能成为肺癌患者的另一种有效治疗方法。本文综述了使用蛋白/肽、全肿瘤细胞和树突状细胞作为肺癌疫苗的最突出的主动特异性免疫治疗方法。
