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Cancer Vaccines · Immunotherapy · Personalized Medicine · Tumor Resistance
Therapeutic cancer vaccines represent a promising immunotherapy for solid tumors, aiming to induce regression and durable antitumor memory while minimizing adverse reactions.
However, the field faces significant hurdles, primarily tumor-induced immune suppression and inherent immune resistance. Unlike immune checkpoint blockade (ICB) or CAR-T therapies, vaccines target the upstream activation of the immune system.
The article categorizes vaccines into predefined antigen vaccines (shared and personalized) and anonymous antigen vaccines. Shared antigen vaccines target common tumor markers like EGFRvIII (found in ~25% of glioblastomas) or HPV E6/E7 proteins (in ~60% of oropharyngeal and nearly all cervical cancers).
Personalized neoantigen vaccines, exemplified by BioNTech's autogene cevumeran, are tailored to individual patients, targeting up to 20 unique neoantigens. Despite ongoing clinical trials for various cancers, challenges include tumor endogenous drug resistance from genetic mutations (e.g., KRAS), tumor heterogeneity, and the immunosuppressive tumor microenvironment (TME) involving factors like cancer-associated fibroblasts (CAFs) and tumor-associated macrophages (TAMs).
The review highlights anonymous antigen vaccines in situ as a new direction to overcome these limitations.
