Schlom Jeffrey, Hodge James W, Palena Claudia, Tsang Kwong-Yok, Jochems Caroline, Greiner John W, Farsaci Benedetto, Madan Ravi A, Heery Christopher R, Gulley James L
Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Adv Cancer Res. 2014;121:67-124. doi: 10.1016/B978-0-12-800249-0.00002-0.
Therapeutic cancer vaccines have the potential of being integrated in the therapy of numerous cancer types and stages. The wide spectrum of vaccine platforms and vaccine targets is reviewed along with the potential for development of vaccines to target cancer cell "stemness," the epithelial-to-mesenchymal transition (EMT) phenotype, and drug-resistant populations. Preclinical and recent clinical studies are now revealing how vaccines can optimally be used with other immune-based therapies such as checkpoint inhibitors, and so-called nonimmune-based therapeutics, radiation, hormonal therapy, and certain small molecule targeted therapies; it is now being revealed that many of these traditional therapies can lyse tumor cells in a manner as to further potentiate the host immune response, alter the phenotype of nonlysed tumor cells to render them more susceptible to T-cell lysis, and/or shift the balance of effector:regulatory cells in a manner to enhance vaccine efficacy. The importance of the tumor microenvironment, the appropriate patient population, and clinical trial endpoints is also discussed in the context of optimizing patient benefit from vaccine-mediated therapy.
治疗性癌症疫苗有可能被整合到多种癌症类型和阶段的治疗中。本文综述了广泛的疫苗平台和疫苗靶点,以及针对癌细胞“干性”、上皮-间质转化(EMT)表型和耐药群体开发疫苗的潜力。临床前和近期的临床研究正在揭示疫苗如何能与其他基于免疫的疗法(如检查点抑制剂)以及所谓的非免疫疗法、放疗、激素疗法和某些小分子靶向疗法最佳地联合使用;现在已经发现,许多这些传统疗法能够以进一步增强宿主免疫反应的方式裂解肿瘤细胞,改变未裂解肿瘤细胞的表型使其更易被T细胞裂解,和/或以增强疫苗疗效的方式改变效应细胞与调节细胞的平衡。在优化患者从疫苗介导治疗中获益的背景下,还讨论了肿瘤微环境、合适的患者群体和临床试验终点的重要性。
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