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Cancer Vaccines: A novel approach to cancer

Cancer Vaccines: A novel approach to cancer. Cancer Statistics. Cancer still remains a major cause of death worldwide despite many therapies and treatment modalities available. ACS predicted in 2006: 565,000 Americans would die of cancer and approximately 1.4 million would be diagnosed.

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Cancer Vaccines: A novel approach to cancer

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  1. Cancer Vaccines:A novel approach to cancer

  2. Cancer Statistics • Cancer still remains a major cause of death worldwide despite many therapies and treatment modalities available. • ACS predicted in 2006: 565,000 Americans would die of cancer and approximately 1.4 million would be diagnosed.

  3. Immunotherapy: New class of cancer treatment • Considered by many to be the “fourth modality of cancer treatment” after chemotherapy, radiation, and surgery. • Based on utilizing the patient’s immune system to fight the cancer. • Cancer vaccines fall under this category of treatment.

  4. Cancer Vaccines • Majority used for treatment not prevention. • May offer method that can enhance the immune response against cancer. • Cancer Vaccines: Different than HPV vaccine and traditional prophylactic vaccines. • HPV Vaccine: Immunity to the virus, which causes cervical cancer. • Traditional prophylactic vaccines: As with the HPV vaccine, provide immunity to a particular disease. • At this time, cancer vaccines are only available in clinical trials.

  5. Science behind Cancer Vaccines Key players • Dendritic Cell: ~Remarkable ability to capture and process antigen. ~ Antigen presenting cell-presents antigen to T-cell to mount an immune response. • T-Cell: ~ Mediates immune response.

  6. 5 Main Types of Cancer Vaccines • Tumor cell vaccines -Autologous vs. Allogenic • Dendritic cell vaccines • Antigen vaccines • Anti-Idiotype vaccines • DNA vaccines

  7. Tumor Cell Vaccines • Utilizes whole tumor cells rendered safe by irradiation. • Specific immune response initiated when injected into body. • Body attacks similar cells that remain in body. • Autologous-removed tumor cells from patient’s own body. • Allogenic-removed tumor cells from someone other than the patient. • Many different epitopes are recognized. • Cancers these vaccines are being studied in: melanoma, colorectal, kidney, ovarian, breast, lung, and leukemia.

  8. Dendritic Cell Vaccines • Dendritic cells can be generated outside of the body. • Dendritic cells are made capable of recognizing antigen by gene therapy and exposure to antigen. • Dendritic cells injected into the individual stimulating an immune response. • Cancers these vaccines are being studied in: prostate, melanoma, breast, lung, colorectal, kidney, leukemia, and non-Hodgkin lymphoma.

  9. Antigen Vaccines • This includes peptide vaccines: only one specific epitope is injected. • Vast amounts of antigen can be created in laboratories. • Some antigens are specific for a certain type of cancer; others may induce an immune response in several cancers. • Cancers these vaccines are being studied in include: kidney cancer, pancreatic cancer, melanoma, ovarian cancer, breast cancer, prostate cancer, and colorectal cancer.

  10. Anti-Idiotype Vaccines • Based on the idea that antibodies can also act as antigens triggering an immune response. • This idea would be used to create a vaccine in which the antibodies (which resemble the cancer cells) would be injected into the cancer patient eliciting an immune response. • Primary target is lymphoma.

  11. DNA vaccines • Introduction of tumor genes instead of tumor antigen itself. • Cells in the body take up the injected DNA. Specific antigens would then be made on a continuous basis. • The idea of these vaccines is that the body would be provided with a constant supply of antigens to allow the immune response to continue against the cancer. • Cancers these vaccines are being studied in: prostate cancer, leukemia, melanoma, and head and neck cancer.

  12. OncoVAX by Intracel • Autologous vaccine for Stage II colon cancer. • Received fast-track status from FDA in 2006. • Used in an adjuvant setting. • Study: 254 patients received either OncoVAX or placebo. • Improves 5-year survival and recurrence-free interval. • 57.1% relative risk reduction.

  13. Sipuleucel-T (Provenge) by Dendreon • Dendritic cell vaccine for treatment of asymptomatic Androgen-Independent Prostate Cancer (AIPC). • Received fast-track status by FDA in 2005. • Target-prostatic acid phosphatase (PAP), which is found in 95% of prostate cancers. • Study of Provenge vs. Placebo. ~98 men with AIPC. ~3.3 month or 21% improvement in median survival. ~3-year follow-up: 32% of men that received Provenge alive compared to 21% placebo. ~52% increase in survival rate.

  14. Lung Cancer Vaccine at UK • Dendritic cell vaccine. • Treatment of non-small cell lung cancer (NSCLC). • Study: Patients with Stage IA to IIIB were given vaccine. • Patients treated prior with surgery, chemoradiation, or multimodality therapy. • Results published for 16 patients. ~5/16: no clear immunologic response. ~5/16: antigen-independent response. ~6/16: response may have been tumor specific. ~response shown in various stages of NSCLC.

  15. Conclusion • Clear that the immune system displays a highly developed response against cancer. • May be more effective in cancers that are not advanced. • Majority will probably be used as adjuvants. • Clinically not yet at our fingertips. • Much progress has been made in this area of research. • More research still needs to be done including larger studies. • Researchers are actively trying to overcome hurdles in the making of these vaccines. • Could make a big impact on our approach to cancer. • Most importantly these vaccines could mean better quality of life and longer survival for our patients!!

  16. References • Armstrong ACª, Eaton D, Ewing JC. Cellular immunity for cancer. British Medical Journal. 2001;323:1289-1293. PMID 11731394. • Armstrong ACb, Hawkins RE. Vaccines in oncology: background and clinical potential. The British Journal of Radiology. 2001;74: 991-1002. PMID 11709463. • Berzofsky JA, Terabe M, Oh S, Belyakov IM, Ahlers JD, Janik JE, et al. Progess on new vaccine strategies for the immunotherapy and prevention of cancer. J. Clin. Interest. 2004; 113:1515-1525. PMID 15173875. • Blattman JN., Greenberg PD. Cancer immunotherapy: A treatment for the masses. Science. 2004;305:200-205. PMID 15247469. • Brand TC, Tolcher AW. Management of high risk metastatic prostate cancer: the case for novel therapies. The Journal of Urology. 2006;176: S76-S80. PMID 17084174. • Cancer.org. [homepage on the Internet]. Atlanta: American Cancer Society, Inc.; c2006. [revised 2005 April 11]. Available from http://www.cancer.org/ • Dendreon.com [homepage on the Internet]. Seattle: Dendreon Corporation c2006. • Available from http://www.dendreon.com/ • Department of Microbiology, Immunology, and Molecular Genetics Faculty Listing. Yannelli JR. University of Kentucky Chandler Medical Center c2004. Available from http://www.mc.uky.edu/microbiology/yannelli.asp • Goldsby RA, Kindt TJ, Osborne BA, Kuby Janis. Immunology. Fifth Ed. New York: W.H. Freeman and Company; 2003. • Groot CA, Vermorken JB, Hanna Jr MG, Verboom P, Groot MT, GJ Bonsel, et al. Immunotherapy with autologous tumor cell-BCG vaccine in patients with colon cancer: a prospective study of medical and economic benefits. ScienceDirect. 2005;23: 2379-2387. • Hirschowitz EA, Foody T, Krysico R, Dickson L, Sturgill J, Yannelli J. Autolougous dendritic cell vaccines for non-small-cell lung cancer. Journal of Clinical Oncology. 2004;22: 2808-2815. • Intracel.com. [homepage on the Internet] Frederick: Intracel Corporation c2006. Available from http://www.intracel.com/ • Tabi Z a, Mann S. Challenges for cancer vaccine development. Science Direct. Advanced Drug Delivery Reviews. In press 2006. • Tabi Zb, Mann S. Human Cancer vaccines. Science Direct. Advanced Drug Delivery Reviews. In press 2006. • Tarassoff CP, Arlen PM, Gulley JL. Therapeutic vaccines for prostate cancer. The Oncologist. 2006;11:451-462. PMID 16720845.

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