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Cancers (Basel). 2011 Aug 5;3(3):3114-42. doi: 10.3390/cancers3033114.
Chemotherapy has been a mainstay in cancer treatment for many years. Despite some success, the cure rate with chemotherapy remains unsatisfactory in some types of cancers, and severe side effects from these treatments are a concern. Recently, understanding of the dynamic interplay between the tumor and immune system has led to the development of novel immunotherapies, including cancer vaccines. Cancer vaccines have many advantageous features, but their use has been hampered by poor immunogenicity. Many developments have increased their potency in pre-clinical models, but cancer vaccines continue to have a poor clinical track record. In part, this could be due to an inability to effectively overcome tumor-induced immune suppression. It had been generally assumed that immune-stimulatory cancer vaccines could not be used in combination with immunosuppressive chemotherapies, but recent evidence has challenged this dogma. Chemotherapies could be used to condition the immune system and tumor to create an environment where cancer vaccines have a better chance of success. Other types of immunotherapies could also be used to modulate the immune system. This review will discuss how immune modulation by chemotherapy or immunotherapy could be used to bolster the effects of cancer vaccines and discuss the advantages and disadvantages of these treatments.
化疗多年来一直是癌症治疗的主要手段。尽管取得了一些成功,但在某些类型的癌症中,化疗的治愈率仍然不尽如人意,这些治疗的严重副作用令人担忧。最近,人们对肿瘤和免疫系统之间的动态相互作用的理解导致了新型免疫疗法的发展,包括癌症疫苗。癌症疫苗具有许多优势特征,但由于免疫原性差,其应用受到限制。许多进展提高了它们在临床前模型中的效力,但癌症疫苗的临床记录仍然不佳。部分原因可能是由于无法有效克服肿瘤诱导的免疫抑制。人们普遍认为,免疫刺激性癌症疫苗不能与免疫抑制化疗联合使用,但最近的证据挑战了这一教条。化疗可用于调节免疫系统和肿瘤,创造一个癌症疫苗更有可能成功的环境。其他类型的免疫疗法也可用于调节免疫系统。这篇综述将讨论化疗或免疫疗法如何通过免疫调节来增强癌症疫苗的效果,并讨论这些治疗方法的优缺点。