Therapeutic vaccines for melanoma - Current status
Therapeutic vaccines for melanoma - Current status
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DOI：
10.2165/00063030-200519040-00004
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发表时间：
2005-01-01
期刊：
影响因子：
6.8
通讯作者：
Morton, DL
中科院分区：
文献类型：
--
作者：
Faries, MB;Morton, DL
大量的临床研究集中于改善黑色素瘤的全身治疗。不幸的是，这种疾病通常对标准化疗有抵抗力，只要有可能，手术切除仍然是最好的治疗选择。然而，在一些患者中观察到黑色素瘤完全自发消退，这种现象被认为是由免疫系统介导的。这刺激了操纵免疫系统用于治疗目的的尝试。疫苗接种是主动特异性免疫疗法的一种形式，患者的免疫系统主动产生针对肿瘤的反应，并针对特定的细胞靶标或特定的膜抗原。人们已经研究了多种黑色素瘤疫苗接种方法，并且随着我们对抗肿瘤免疫了解的加深，这些方法变得更加复杂。疫苗已被证明可以诱导可测量的免疫反应，这可能与黑色素瘤患者临床结果的改善相关。使用肽、神经节苷脂和全细胞肿瘤抗原的大型 III 期临床试验正在进行中。尽管抗肿瘤疫苗接种在黑色素瘤患者中显示出有希望的结果，但迄今为止还没有疫苗被批准用于黑色素瘤的常规治疗。最近，一项评估 Canvaxin 全细胞疫苗治疗 IV 期黑色素瘤的 III 期试验因显着获益的可能性较低而被叫停。然而，针对 III 期疾病患者的更大规模的 III 期试验仍在继续，并且正在等待结果。
Considerable clinical research is focused on improving systemic treatments for melanoma. Unfortunately, the disease is generally resistant to standard chemotherapy, and surgical excision remains the best treatment option whenever possible. However, complete spontaneous regression of melanoma has been observed in some patients, a phenomenon thought to be mediated by the immune system. This has stimulated attempts to manipulate the immune system for therapeutic purposes. Vaccination is a form of active specific immunotherapy, such that the response against the tumor is actively generated by the patient's immune system, and is directed against a particular cellular target or specific membrane antigen. Numerous approaches to vaccination for melanoma have been investigated, and have become more complex as our understanding of anti-tumor immunity has increased. Vaccines have been shown to induce measurable immunologic responses that may be correlated with improved clinical outcomes in patients with melanoma. Large phase III clinical trials using peptide, ganglioside, and whole-cell tumor antigens are ongoing. Although anti-tumor vaccination has shown promising results in patients with melanoma, to date no vaccine has been approved for routine therapy of melanoma. Recently, a phase III trial evaluating the Canvaxin whole-cell vaccine in stage IV melanoma was halted because of a low likelihood of significant benefit. However, a larger phase III trial for patients with stage III disease was continued and results are awaited with interest.