Vaccine-Based Immunotherapy and Targeting the Tumor Microenvironment in Renal Cell Carcinoma

Chapter

Abstract

Despite the recent emergence of pathway-targeted therapies, no curative treatment for metastatic renal cell carcinoma (RCC) exists to date, thus fostering continued interest in developing new treatment strategies to eradicate renal malignancy. Active specific immunotherapy via cancer vaccines is one alternative approach that has shown clinical activity in several solid tumor systems, including RCC. However, critical questions regarding the optimal vaccine design, molecular effector mechanisms, vaccine delivery, and optimal vaccine–drug synergisms are, at present, only poorly understood. In addition, tumor-derived factors lead to profound immunosuppression in the cancer patient, thus mitigating the therapeutic effects of cancer vaccination. New insights suggest that effective stimulation of therapeutically useful antitumor responses requires the development of immunization protocols that fulfill two major criteria: (a) overcoming tumor-induced immunosuppression and (b) stimulating robust T-cell responses against tumor-associated antigens via an optimized vaccine approach. Such dual-pronged strategies represent important directions for the future advancements of anticancer vaccines toward clinical practice. In this chapter, the basic concepts and current approaches of RCC vaccination are discussed, and the molecular and cellular components in the tumor microenvironment that mediate immunosuppression are described. We further point out new insights suggesting synergies between active immunotherapy approaches, multikinase inhibitors, and other forms of targeted therapy.

Keywords

Placebo Cholesterol Toxicity Tyrosine Polypeptide 

Notes

Acknowledgments

Some of the results referred to in this manuscript were in part supported by grants from the National Cancer Institute (K24 CA118454-04).

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Urology and Prostate Disease Center, College of MedicineUniversity of FloridaGainesvilleUSA

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