a Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute , National Institutes of Health , Bethesda , MD , USA.
Expert Rev Vaccines. 2018 Aug;17(8):697-705. doi: 10.1080/14760584.2018.1506332. Epub 2018 Aug 22.
INTRODUCTION: Multiple immune checkpoint inhibitors (ICIs) that modulate immune cells in the periphery and the tumor microenvironment (TME) have been approved, as have the therapeutic cancer vaccines sipuleucel-T for metastatic castration-resistant prostate cancer and talimogene laherparepvec (T-VEC) for metastatic melanoma. These developments provide rationale for combining these modalities to improve response rates and durability of responses in a variety of cancers. Preclinical data have shown that vaccines can induce immune responses that turn a tumor from 'cold' to 'hot,' but vaccines do not appear to be highly active as monotherapy. AREAS COVERED: Here, we provide a review of the current state of vaccine and ICI combination studies. EXPERT COMMENTARY: Most combination trials are in early phases, but several are now in phase III. Vaccines that target antigens expressed exclusively on tumor cells, neoantigens, have the potential to induce robust antitumor responses. Several techniques for predicting which neoepitopes to target, based on tumor mutational profiling, are in various stages of development. To be successful, combination immunotherapy approaches must seek to prime the immune system, expand the immune response, and facilitate immune function within the TME.
简介:已批准多种外周免疫检查点抑制剂(ICI)和肿瘤微环境(TME)调节剂,包括用于转移性去势抵抗性前列腺癌的 sipuleucel-T 和用于转移性黑色素瘤的 talimogene laherparepvec(T-VEC)等治疗性癌症疫苗。这些进展为联合这些方法提供了依据,以提高各种癌症的反应率和反应持久性。临床前数据表明,疫苗可以诱导免疫反应,使肿瘤从“冷”变“热”,但疫苗作为单一疗法似乎效果不高。
涵盖领域:本文综述了疫苗与 ICI 联合研究的现状。
专家评论:大多数联合试验处于早期阶段,但现在已有几个进入了 III 期。针对仅在肿瘤细胞上表达的抗原(即新抗原)的疫苗有可能引发强烈的抗肿瘤反应。目前有几种基于肿瘤突变分析预测要靶向的新表位的技术正在不同阶段开发中。为了取得成功,联合免疫治疗方法必须寻求刺激免疫系统、扩大免疫反应,并促进 TME 中的免疫功能。
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