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The Promise of Preventive Cancer Vaccines.

Lollini PL, Cavallo F, Nanni P, Quaglino E - Vaccines (Basel) (2015)

Bottom Line: Years of unsuccessful attempts at fighting established tumors with vaccines have taught us all that they are only able to truly impact patient survival when used in a preventive setting, as would normally be the case for traditional vaccines against infectious diseases.While true primary cancer prevention is still but a long-term goal, secondary and tertiary prevention are already in the clinic and providing encouraging results.A combination of immunopreventive cancer strategies and recently approved checkpoint inhibitors is a further promise of forthcoming successful cancer disease control, but prevention will require a considerable reduction of currently reported toxicities.

View Article: PubMed Central - PubMed

Affiliation: Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Viale Filopanti 22, Bologna 40126, Italy. pierluigi.lollini@unibo.it.

ABSTRACT
Years of unsuccessful attempts at fighting established tumors with vaccines have taught us all that they are only able to truly impact patient survival when used in a preventive setting, as would normally be the case for traditional vaccines against infectious diseases. While true primary cancer prevention is still but a long-term goal, secondary and tertiary prevention are already in the clinic and providing encouraging results. A combination of immunopreventive cancer strategies and recently approved checkpoint inhibitors is a further promise of forthcoming successful cancer disease control, but prevention will require a considerable reduction of currently reported toxicities. These considerations summed with the increased understanding of tumor antigens allow space for an optimistic view of the future.

No MeSH data available.


Related in: MedlinePlus

Schematic representation of the different anti-cancer vaccination strategies. The three broad types of cancer vaccines used are shown. Cell-based vaccines include cancer cells or, most often, DC pulsed or transfected with various sources of tumor antigens as depicted in the inset.
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vaccines-03-00467-f001: Schematic representation of the different anti-cancer vaccination strategies. The three broad types of cancer vaccines used are shown. Cell-based vaccines include cancer cells or, most often, DC pulsed or transfected with various sources of tumor antigens as depicted in the inset.

Mentions: There are three broad types of cancer vaccines: cell-, protein/peptide-, and gene-based vaccines (Figure 1), and none of them are devoid of pitfalls. Cell-based vaccines can be prepared with autologous or allogeneic tumor cells [21], or most often with autologous dendritic cells (DC) pulsed or transfected with tumor antigens in various forms (i.e., tumor lysates, purified proteins or peptides, DNA or RNA) [22]. However, immunogenic, cell-based vaccines have features that hamper their cost-effective, large-scale production as exemplified by sipuleucel-T odyssey (which is further examined in Section 3.3). Being molecularly defined synthetic vaccines, protein/peptide- and gene-based vaccines are more suitable for large-scale pharmaceutical manufacturing processes. However, the former display a limited immunogenicity, thus requiring the use of adjuvants. In the case of peptides, a further limitation is represented by the fact that their application is limited to patients with specific human leukocyte antigen (HLA) molecules [23]. The major drawback of gene-based vaccines is their limited uptake and consequent limited antigen transcription by transfected cells [24]. Their administration through electroporation or viral-mediated delivery solves the issue but opens new problems. In the case of electroporation, the availability of clinically approved devices and patients’ compliance have limited, until now, their use in clinic [25]. In the case of viral-mediated delivery, the problems are mainly related to potential dangers associated with the administration of live virus together with the presence of anti-viral neutralizing antibodies in patients [26].


The Promise of Preventive Cancer Vaccines.

Lollini PL, Cavallo F, Nanni P, Quaglino E - Vaccines (Basel) (2015)

Schematic representation of the different anti-cancer vaccination strategies. The three broad types of cancer vaccines used are shown. Cell-based vaccines include cancer cells or, most often, DC pulsed or transfected with various sources of tumor antigens as depicted in the inset.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494347&req=5

vaccines-03-00467-f001: Schematic representation of the different anti-cancer vaccination strategies. The three broad types of cancer vaccines used are shown. Cell-based vaccines include cancer cells or, most often, DC pulsed or transfected with various sources of tumor antigens as depicted in the inset.
Mentions: There are three broad types of cancer vaccines: cell-, protein/peptide-, and gene-based vaccines (Figure 1), and none of them are devoid of pitfalls. Cell-based vaccines can be prepared with autologous or allogeneic tumor cells [21], or most often with autologous dendritic cells (DC) pulsed or transfected with tumor antigens in various forms (i.e., tumor lysates, purified proteins or peptides, DNA or RNA) [22]. However, immunogenic, cell-based vaccines have features that hamper their cost-effective, large-scale production as exemplified by sipuleucel-T odyssey (which is further examined in Section 3.3). Being molecularly defined synthetic vaccines, protein/peptide- and gene-based vaccines are more suitable for large-scale pharmaceutical manufacturing processes. However, the former display a limited immunogenicity, thus requiring the use of adjuvants. In the case of peptides, a further limitation is represented by the fact that their application is limited to patients with specific human leukocyte antigen (HLA) molecules [23]. The major drawback of gene-based vaccines is their limited uptake and consequent limited antigen transcription by transfected cells [24]. Their administration through electroporation or viral-mediated delivery solves the issue but opens new problems. In the case of electroporation, the availability of clinically approved devices and patients’ compliance have limited, until now, their use in clinic [25]. In the case of viral-mediated delivery, the problems are mainly related to potential dangers associated with the administration of live virus together with the presence of anti-viral neutralizing antibodies in patients [26].

Bottom Line: Years of unsuccessful attempts at fighting established tumors with vaccines have taught us all that they are only able to truly impact patient survival when used in a preventive setting, as would normally be the case for traditional vaccines against infectious diseases.While true primary cancer prevention is still but a long-term goal, secondary and tertiary prevention are already in the clinic and providing encouraging results.A combination of immunopreventive cancer strategies and recently approved checkpoint inhibitors is a further promise of forthcoming successful cancer disease control, but prevention will require a considerable reduction of currently reported toxicities.

View Article: PubMed Central - PubMed

Affiliation: Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Viale Filopanti 22, Bologna 40126, Italy. pierluigi.lollini@unibo.it.

ABSTRACT
Years of unsuccessful attempts at fighting established tumors with vaccines have taught us all that they are only able to truly impact patient survival when used in a preventive setting, as would normally be the case for traditional vaccines against infectious diseases. While true primary cancer prevention is still but a long-term goal, secondary and tertiary prevention are already in the clinic and providing encouraging results. A combination of immunopreventive cancer strategies and recently approved checkpoint inhibitors is a further promise of forthcoming successful cancer disease control, but prevention will require a considerable reduction of currently reported toxicities. These considerations summed with the increased understanding of tumor antigens allow space for an optimistic view of the future.

No MeSH data available.


Related in: MedlinePlus