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MINIREVIEW

Paradigm Shifts in Cancer Vaccine Therapy

Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892

To whom requests for reprints should be addressed at ¹ Laboratory of Tumor Immunology and Biology, CCR, NCI, 10 Center Drive, Room 8B09, Bethesda, MD 20892. E-mail: js141c{at}nih.gov

Cancer vaccines constitute a unique therapeutic modality in that they initiate a dynamic process involving the host’s immune response. Consequently, (a) repeated doses (vaccinations) over months may be required before patient clinical benefit is observed and (b) there most likely will be a "dynamic balance" between the induction and maintenance of host immune response elements to the vaccinations vs. host/tumor factors that have the potential to diminish those responses. Thus "patient response" in the form of disease stabilization and prolonged survival may be more appropriate to monitor than strictly adhering to "tumor response" in the form of Response Criteria In Solid Tumors (RECIST) criteria. This can be manifested in the form of enhanced patient benefit to subsequent therapies following vaccine therapy. This article will review these phenomena unique to cancer vaccines with emphasis on prostate cancer vaccines as a prototype for vaccine therapy. The unique features of this modality require the consideration of paradigm shifts both in the way cancer vaccine clinical trials are designed and in the way patient benefit is evaluated.

Key Words: cancer vaccines • immunotherapy • combination therapy • prostate cancer

This article has been cited by other articles:

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