From the Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Jeffrey Schlom, PhD, Chief, Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, Room 8B09, Bethesda, MD, 20892; e-mail: js141c{at}nih.gov
Overview: Cancer vaccines are undergoing both preclinical and clinical investigations. Although no therapeutic cancer vaccine has been approved by the U.S. Food and Drug Administration, several new paradigms have emerged from recent clinical findings in both the use of combination therapy approaches and, perhaps more importantly, in clinical trial design and endpoint analyses. This article reviews recent clinical trials involving different cancer vaccines from which data are emerging and contrasting classical tumor response (Response Criteria in Solid Tumors [RECIST]) criteria with increased patient survival postvaccine therapy. Several strategies for using cancer vaccines combined with other agents and therapeutic modalities that are unique compared with conventional combination therapies are also reviewed. This is most likely a result of cancer vaccines initiating a dynamic immune process that can be exploited in subsequent therapies, and both radiation and certain chemotherapeutic agents altering the phenotype of tumor cells, thus rendering them more susceptible to T-cell–mediated killing. Consequently, several studies are providing evidence that patient groups that receive a cancer vaccine receive greater clinical benefit from subsequent therapies than control groups.
