a Department of Gastroenterological, Breast and Endocrine Surgery , Yamaguchi University Graduate School of Medicine , Ube , Japan.
b Department of Translational Research and Developmental Therapeutics against Cancer , Yamaguchi University School of Medicine , Yamaguchi , Japan.
Expert Rev Anticancer Ther. 2018 Dec;18(12):1205-1217. doi: 10.1080/14737140.2018.1531707. Epub 2018 Oct 10.
Pancreatic cancer is a highly malignant disease with high treatment resistance. Many patients are diagnosed in a very advanced state, and few patients can be curatively resected. With FOLFIRINOX and nab-paclitaxel plus gemcitabine, the prognosis of advanced pancreatic cancer has improved, yet many patients cannot survive longer than a year. Therefore, new therapeutic approaches are needed. Cancer vaccine therapy is characterized by controlling cancer by a cancer-specific immune reaction with few adverse events. Thus, a cancer peptide vaccine is considered promising for pancreatic cancer patients, who are often in poor general condition at diagnosis. Areas covered: This article reviews available data from recent clinical trials of the novel cancer vaccine therapy in combination with traditional chemotherapy or radiotherapy for pancreatic cancer, and the prospect will be described. Expert commentary: In clinical trials of the novel cancer vaccine therapy in combination with traditional therapy, many studies have failed to outperform traditional therapy, although some effects were recognized in subgroups. What is necessary in the future for cancer vaccine therapy to improve the prognosis of pancreatic cancer is combination of immune-checkpoint blockade to release immune escape mechanism and combination with strong multi-drug combination chemotherapy.
胰腺癌是一种高度恶性的疾病,具有很高的治疗抵抗性。许多患者在非常晚期才被诊断出来,只有少数患者可以进行根治性切除。随着 FOLFIRINOX 和 nab-紫杉醇加吉西他滨的应用,晚期胰腺癌的预后有所改善,但许多患者的生存期仍不能超过一年。因此,需要新的治疗方法。癌症疫苗治疗的特点是通过针对癌症的特异性免疫反应来控制癌症,不良反应较少。因此,癌症肽疫苗被认为对诊断时常处于一般状况较差的胰腺癌患者有希望。
本文综述了最近的临床试验中,新型癌症疫苗疗法与传统化疗或放疗联合治疗胰腺癌的可用数据,并描述了其前景。
在新型癌症疫苗疗法与传统治疗联合的临床试验中,虽然在某些亚组中观察到了一些效果,但许多研究未能优于传统治疗。未来,癌症疫苗疗法要改善胰腺癌的预后,需要联合免疫检查点阻断以释放免疫逃逸机制,并与强的多药物联合化疗联合应用。