Improving the efficacy of cancer immunotherapy
Improving the efficacy of cancer immunotherapy
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DOI：
10.1016/j.ejca.2008.12.017
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发表时间：
2009-05-01
影响因子：
8.4
通讯作者：
Hakansson, L.
中科院分区：
文献类型：
--
作者：
Copier, J.;Dalgleish, A. G.;Hakansson, L.
一系列癌症疫苗已在临床试验中进行了评估，取得了令人鼓舞的结果，但迄今为止，在验证性研究中证明临床益处仍很困难。癌症疫苗的开发受到该研究领域特有的一系列问题的阻碍。 2008年3月12日，生物治疗发展协会召开了一次研讨会，讨论参与癌症疫苗开发的科学家和临床医生所面临的问题。本文基于 BDA 研讨会上的讨论对该领域进行了综述，描述了在对肿瘤产生有效免疫反应时遇到的生物障碍、在改进免疫监测（旨在改善实验室间和试验间比较）方面遇到的方法学障碍、临床试验设计中的挑战以及癌症疫苗缺乏具体监管所带来的问题及其对其开发的影响。最终，提出了一些通用解决方案：(1) 更好的患者选择，(2) 使用同时影响免疫系统多个方面的多模式治疗，(3) 需要开发良好的生物标志物，以在试验前对患者进行分层，并作为临床反应的替代指标，以及 (4) 协调临床试验免疫学监测的 SOP。 (C) 2009 年，爱思唯尔有限公司出版。
A series of cancer vaccines have been evaluated in clinical trials with encouraging results, but the demonstration of clinical benefit in confirmatory studies has so far proven to be difficult. The development of cancer vaccines is hampered by a range of issues particular to this field of research. On 12th March 2008, the Biotherapy Development Association convened a workshop to discuss issues faced by scientists and clinicians involved in the development of cancer vaccines. This paper is a review of the field, based on discussions held at the BDA workshop, and describes biological barriers encountered in generating effective immune responses to tumours, methodological obstacles encountered in the improvement of immunological monitoring which aims to improve inter-laboratory and inter-trial comparisons, challenges in clinical trial design and problems posed by the lack of specific regulation for cancer vaccines and the impact on their development. Ultimately, a number of general solutions are posed: (1) better patient selection, (2) use of multi-modal treatments that affect several aspects of the immune system at once, (3) a requirement for the development of good biomarkers to stratify patients for selection prior to trial and as surrogates for clinical response and (4) harmonisation of SOPs for immunological monitoring of clinical trials. (C) 2009 Published by Elsevier Ltd.