Vaccines for Breast Cancer: Real Challenge or Reality?

Walter Sall, MD
Abramson Cancer Center of the University of Pennsylvania
Ultima Vez Modificado: 13 de noviembre del 2003

Share article


Faculty Disclosure: Nuhad K. Ibrahim, MD
This presentation by Dr. Ibrahim discusses the use of the STn vaccine for the treatment of breast cancer which has not been approved by the FDA.

Presenter: Nuhad K. Ibrahim, MD
Affiliation: M.D. Anderson Cancer Center

Vaccine mediated cancer therapies are theoretically attractive for many reasons: augmentation of native anti-tumor immunity, specific targeting of tumor antigens, low toxicity enabling combination with cytotoxic chemotherapy, and induction of anti-tumor immunologic memory providing for a surveillance effect. These theoretical benefits have been difficult to realize clinically, though progress has been made. The limitations of vaccine therapies are many and include: the fact that most tumor antigens are self antigens and not tumor specific, that tumors secrete immunosuppressive cytokines, and that anergy may exist limiting T cell amplification.

Several tumor epitopes are currently the targets of vaccine research. These include: CEA, Her2-neu, p53, MUC-1 and STn. STn vaccine is furthest along in the development process. The STn antigen is formed by the aberrant glycosylation of a normally occuring membrane bound polysaccharide. Naturally occuring antibodies to this epitope have been found in breast cancer patients making it a good choice for vaccine development. In clinical trials, synthetic STn is used to immunize patients after pretreatment with low dose cyclophosphamide, the intent of which is to inhibit suppressor T-cells. Phase I/II trials have shown induction of anti-STn IgG antibodies. In the metastatic setting, clinical responses appear to have been seen. A phase III trial is underway, with accrual goal of over 1000 patients.

In order to improve the vaccine, several strategies are being pursued: use of dexasomes to bolster the immunologic response to the vaccine, novel viral vectors to deliver the vaccine epitope and improvement of the inherent immunogenicity of the vaccine epitope. Surrogate endpoints other than survival and tumor response must be developed to help monitor efficacy of these vaccines. One such test is the ELISPOT test.

Future directions of this research will help to determine how vaccines will fit into the standard cytotoxic chemotherapy regimens being used today. It is unclear whether sequential or concommitant use will be best.

Preliminary research shows that breast cancer vaccines have anti-tumor activity and little toxicity. Further investigation is needed to evaluate the magnitude of the benefit and to develop new, more specific and potent vaccine agents.


News
AACR: UV Radiation Linked to Risk of Pancreatic Cancer

Jun 22, 2012 - Exposure to high ultraviolet radiation seems to confer a lower risk of pancreatic cancer, and measures of skin type correlate significantly with the risk of pancreatic cancer, according to a study presented at the American Association for Cancer Research's Pancreatic Cancer: Progress and Challenges conference, held from June 18 to 21 in Lake Tahoe, Nev.



I Wish You Knew

How cancer patients have changed my life

View More



Blogs and Web Chats

OncoLink Blogs give our readers a chance to react to and comment on key cancer news topics and provides a forum for OncoLink Experts and readers to share opinions and learn from each other.




OncoLink OncoPilot

Frente a un nuevo diagnóstico de cáncer o de cambiar el curso de su tratamiento actual? Deje que nuestro personal de enfermería cáncer que ayudan a pasar!

Más información