Surolia Ira, Gulley James, Madan Ravi A
National Institute of Health , Bethesda, MD , USA.
Expert Opin Biol Ther. 2014 Dec;14(12):1769-81. doi: 10.1517/14712598.2014.955010. Epub 2014 Sep 12.
Despite a recent increase in US FDA-approved treatments, genitourinary malignancies remain a source of significant morbidity and mortality. One focus of research is the use of therapeutic cancer vaccines in these diseases, and a significant body of clinical trial experience now exists for refining vaccine strategies to enhance antitumor efficacy and develop immune-based combination regimens.
In recent years, clinical data from multiple trials in genitourinary malignancies have enhanced our understanding of the potential for immunotherapy in these cancers. There are also emerging clinical strategies that combine cancer vaccines with chemotherapy, radiation, androgen-deprivation therapy and immune checkpoint inhibitors. This review is based on a search of relevant literature for data presented over the past 5 years from clinical trials of cancer vaccines in prostate, bladder and renal carcinomas.
In the coming years, clinical trials informed by decades of preclinical data and emerging clinical data will help to define the role of immunotherapy in genitourinary malignancies. Combination strategies that capitalize on the immune properties of standard treatments will bring greater clinical benefits, and immune-based combinations will likely be moved to the neoadjuvant setting, where they may have optimal clinical impact.
尽管美国食品药品监督管理局（FDA）近期批准的治疗方法有所增加，但泌尿生殖系统恶性肿瘤仍然是导致严重发病和死亡的原因。研究的一个重点是在这些疾病中使用治疗性癌症疫苗，现在已有大量临床试验经验用于完善疫苗策略，以提高抗肿瘤疗效并开发基于免疫的联合治疗方案。
近年来，泌尿生殖系统恶性肿瘤多项试验的临床数据加深了我们对这些癌症免疫治疗潜力的理解。也有一些新出现的临床策略将癌症疫苗与化疗、放疗、雄激素剥夺疗法和免疫检查点抑制剂相结合。本综述基于对相关文献的检索，以获取过去5年前列腺癌、膀胱癌和肾癌癌症疫苗临床试验所呈现的数据。
在未来几年，由数十年临床前数据和新出现的临床数据指导的临床试验将有助于明确免疫治疗在泌尿生殖系统恶性肿瘤中的作用。利用标准治疗的免疫特性的联合策略将带来更大的临床益处，基于免疫的联合治疗可能会进入新辅助治疗阶段，在那里它们可能产生最佳的临床效果。
