Abstract
Numerous different kinds of cancer vaccines are in development, comprising a broad spectrum of different antigenic targets and formulations. Although many cancer vaccination trials have been conducted through the last decades, clinical benefit for the majority of patients still needs to be confirmed. An obstacle to successive immunotherapy might be immunosuppressive mechanisms such as regulatory T cells and myeloid-derived suppressor cells.
The use of chemotherapy in combination with immunotherapy has been controversial due to the immunosuppressive effects of the chemotherapeutic agents. During the last decade, data have accumulated that point to possible advantages of combining these two treatments. To this end, some chemotherapeutic drugs lead to an immunogenic death of cancer cells and selective depletion of immunoregulatory cell subsets.
The combination of immunotherapy and standard chemotherapy regimens or low-dose chemotherapy aiming at improved response to immunotherapy is under investigation in numerous laboratories and clinics, and the results look promising so far.
The cancer vaccine approach might also benefit from combination with other kinds of cancer therapeutics such as targeted therapies and immune-modifying antibodies.
Selected studies are reviewed to address present knowledge on combining cancer vaccines and existing cancer therapies. Also future perspectives are discussed.
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Higano, C.S., et al.: Sipuleucel-T. Nat. Rev. Drug Discov. 9, 513–514 (2010)
Schreiber, R.D., Old, L.J., Smyth, M.J.: Cancer immunoediting: integrating immunity’s roles in cancer suppression and promotion. Science 331, 1565–1570 (2011)
Zou, W.: Regulatory T cells, tumour immunity and immunotherapy. Nat. Rev. Immunol. 6, 295–307 (2006)
Srivastava, M.K., et al.: Myeloid-derived suppressor cells inhibit T-cell activation by depleting cystine and cysteine. Cancer Res. 70, 68–77 (2010)
Munn, D.H., Mellor, A.L.: Indoleamine 2,3-dioxygenase and tumor-induced tolerance. J. Clin. Invest. 117, 1147–1154 (2007)
Andersen, M.H.: The specific targeting of immune regulation: T-cell responses against indoleamine 2,3-dioxygenase. Cancer Immunol. Immunother. 61, 1289–1297 (2012), 1–9
Emens, L.A.: Chemoimmunotherapy. Cancer J. 16, 295–303 (2010)
Sistigu, A., et al.: Immunomodulatory effects of cyclophosphamide and implementations for vaccine design. Semin. Immunopathol. 33, 369–383 (2011)
Zitvogel, L., et al.: Immunogenic tumor cell death for optimal anticancer therapy: the calreticulin exposure pathway. Clin. Cancer Res. 16, 3100–3104 (2010)
Aymeric, L., et al.: Tumor cell death and ATP release prime dendritic cells and efficient anticancer immunity. Cancer Res. 70, 855–858 (2010)
Ramakrishnan, R., et al.: Chemotherapy enhances tumor cell susceptibility to CTL-mediated killing during cancer immunotherapy in mice. J. Clin. Invest. 120, 1111–1124 (2010)
Liu, J.Y., et al.: Single administration of low dose cyclophosphamide augments the antitumor effect of dendritic cell vaccine. Cancer Immunol. Immunother. 56, 1597–1604 (2007)
Lutsiak, M.E., et al.: Inhibition of CD4(+)25+ T regulatory cell function implicated in enhanced immune response by low-dose cyclophosphamide. Blood 105, 2862–2868 (2005)
Ge, Y., et al.: Metronomic cyclophosphamide treatment in metastasized breast cancer patients: immunological effects and clinical outcome. Cancer Immunol. Immunother. 61, 353–362 (2012)
Emens, L.A., et al.: Timed sequential treatment with cyclophosphamide, doxorubicin, and an allogeneic granulocyte-macrophage colony-stimulating factor-secreting breast tumor vaccine: a chemotherapy dose-ranging factorial study of safety and immune activation. J. Clin. Oncol. 27, 5911–5918 (2009)
Holtl, L., et al.: Allogeneic dendritic cell vaccination against metastatic renal cell carcinoma with or without cyclophosphamide. Cancer Immunol. Immunother. 54, 663–670 (2005)
Ghiringhelli, F., et al.: Metronomic cyclophosphamide regimen selectively depletes CD4 + CD25+ regulatory T cells and restores T and NK effector functions in end stage cancer patients. Cancer Immunol. Immunother. 56, 641–648 (2007)
Ellebaek, E., et al.: Metastatic melanoma patients treated with dendritic cell vaccination, interleukin-2 and metronomic cyclophosphamide: results from a phase II trial. Cancer Immunol. Immunother. 61, 1791–1804 (2012)
Engell-Noerregaard, L., et al.: Influence of metronomic cyclophosphamide or interleukin-2 alone or combined on blood regulatory T cells in patients with advanced malignant melanoma treated with dendritic cell vaccines. J. Clin. Cell. Immunol 3, 1 (2012)
Kyte, J.A., et al.: Telomerase peptide vaccination combined with temozolomide: a clinical trial in stage IV melanoma patients. Clin. Cancer Res. 17, 4568–4580 (2011)
Harrop, R., et al.: Vaccination of colorectal cancer patients with modified vaccinia Ankara delivering the tumor antigen 5T4 (TroVax) induces immune responses which correlate with disease control: a phase I/II trial. Clin. Cancer Res. 12, 3416–3424 (2006)
Harrop, R., et al.: Vaccination of colorectal cancer patients with modified vaccinia ankara encoding the tumor antigen 5T4 (TroVax) given alongside chemotherapy induces potent immune responses. Clin. Cancer Res. 13, 4487–4494 (2007)
Harrop, R., et al.: Vaccination of colorectal cancer patients with TroVax given alongside chemotherapy (5-fluorouracil, leukovorin and irinotecan) is safe and induces potent immune responses. Cancer Immunol. Immunother. 57, 977–986 (2008)
Nistico, P., et al.: Chemotherapy enhances vaccine-induced antitumor immunity in melanoma patients. Int. J. Cancer 124, 130–139 (2009)
Quoix, E., et al.: Therapeutic vaccination with TG4010 and first-line chemotherapy in advanced non-small-cell lung cancer: a controlled phase 2B trial. Lancet Oncol. 12, 1125–1133 (2011)
Obeid, M., et al.: Calreticulin exposure dictates the immunogenicity of cancer cell death. Nat. Med. 13, 54–61 (2007)
Chakraborty, M., et al.: External beam radiation of tumors alters phenotype of tumor cells to render them susceptible to vaccine-mediated T-cell killing. Cancer Res. 64, 4328–4337 (2004)
Formenti, S.C., Demaria, S.: Systemic effects of local radiotherapy. Lancet Oncol. 10, 718–726 (2009)
Butts, C., et al.: Updated survival analysis in patients with stage IIIB or IV non-small-cell lung cancer receiving BLP25 liposome vaccine (L-BLP25): phase IIB randomized, multicenter, open-label trial. J. Cancer Res. Clin. Oncol. 137, 1337–1342 (2011)
Gulley, J.L., et al.: Combining a recombinant cancer vaccine with standard definitive radiotherapy in patients with localized prostate cancer. Clin. Cancer Res. 11, 3353–3362 (2005)
Masucci, G., et al.: Stereotactic Ablative Radio Therapy (SABR) followed by immunotherapy a challenge for individualized treatment of metastatic solid tumours. J. Transl. Med. 10, 104 (2012)
Coppin, C., et al.: Targeted therapy for advanced renal cell cancer (RCC): a Cochrane systematic review of published randomised trials. BJU Int. 108, 1556–1563 (2011)
Escudier, B., Kataja, V.: Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 21(Suppl 5), v137–v139 (2010)
Bhatia, S., Thompson, J.A.: Systemic therapy for metastatic melanoma in 2012: dawn of a new era. J. Natl. Compr. Canc. Netw. 10, 403–412 (2012)
Blank, C.U., Hooijkaas, A.I., Haanen, J.B., Schumacher, T.N.: Combination of targeted therapy and immunotherapy in melanoma. Cancer Immunol. Immunother. 60, 1359–1371 (2011)
Comin-Anduix, B., et al.: The oncogenic BRAF kinase inhibitor PLX4032/RG7204 does not affect the viability or function of human lymphocytes across a wide range of concentrations. Clin. Cancer Res. 16, 6040–6048 (2010)
Hong, D.S., et al.: BRAF(V600) inhibitor GSK2118436 targeted inhibition of mutant BRAF in cancer patients does not impair overall immune competency. Clin. Cancer Res. 18, 2326–2335 (2012)
Boni, A., et al.: Selective BRAFV600E inhibition enhances T-cell recognition of melanoma without affecting lymphocyte function. Cancer Res. 70, 5213–5219 (2010)
Donia, M., et al.: Methods to improve adoptive T-cell therapy for melanoma: IFN-γ enhances anticancer responses of cell products for infusion. J. Invest. Dermatol. 133, 545–552 (2013)
Schwartzentruber, D.J., et al.: gp100 peptide vaccine and interleukin-2 in patients with advanced melanoma. N. Engl. J. Med. 364, 2119–2127 (2011)
Weber, J.S., et al.: Ipilimumab increases activated T cells and enhances humoral immunity in patients with advanced melanoma. J. Immunother. 35, 89–97 (2012)
Hodi, F.S., et al.: Improved survival with ipilimumab in patients with metastatic melanoma. N. Engl. J. Med. 363, 711–723 (2010)
Prieto, P.A., et al.: CTLA-4 blockade with ipilimumab: long-term follow-up of 177 patients with metastatic melanoma. Clin. Cancer Res. 18, 2039–2047 (2012)
Helmbach, H., et al.: Drug-resistance in human melanoma. Int. J. Cancer. 93, 617–622 (2001)
Wendel, H.G., Lowe, S.W.: Reversing drug resistance in vivo. Cell Cycle 3, 847–849 (2004)
Rochat, B., et al.: Human CYP1B1 and anticancer agent metabolism: mechanism for tumor-specific drug inactivation? J. Pharmacol. Exp. Ther. 296, 537–541 (2001)
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Ellebæk, E., Andersen, M.H., Svane, I.M. (2013). Cancer Vaccines and the Potential Benefit of Combination with Standard Cancer Therapies. In: Giese, M. (eds) Molecular Vaccines. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1419-3_20
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DOI: https://doi.org/10.1007/978-3-7091-1419-3_20
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