DiaLog: Cancer Vaccines and Immunotherapy

From OncoLog, May 2006, Vol. 51, No. 5

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Cancer Vaccines and Immunotherapy

Patrick Hwu, M.D., Professor and Chair, Department of Melanoma Medical Oncology

Over the past century, perhaps the medical advance with the greatest impact on global health has been the development of vaccines to prevent infectious diseases. Many cancer researchers are now working to harness the power of the immune system against cancer.

The immune system consists of a diverse group of cells that work together in coordinating an attack on invading pathogens. Dendritic cells are the sentinels that first detect the invading pathogens and subsequently stimulate the lymphocytes, which can eliminate the invaders. Lymphocytes are capable of recognizing small molecular differences in antigens. Therefore, cancer vaccines, which aim to stimulate the immune response against cancer, may be an ideal means to molecularly target tumors.

However, it is significantly more challenging to develop vaccines against cancer than against bacteria and viruses because tumors are not foreign invaders. Despite these challenges, we are making significant progress. We are applying principles learned from the natural immune response against pathogens to the generation of an antitumor immune response.

Although vaccines against infectious diseases have been highly successful, they can only prevent disease and are not able to treat active infections. This is because it can take several weeks to mount an optimal immune response. Therefore, it may be unrealistic to think that we will be able to treat active metastatic cancer with a vaccine alone. Perhaps ultimately the best use of cancer vaccines will be to prevent cancer recurrence once the initial disease has been eliminated with surgery or chemotherapy. This situation applies to a large proportion of patients who present with cancer.

For patients with more advanced disease, we have had some success with adoptive T-cell therapy, which is the infusion of large numbers of tumor-reactive lymphocytes. In people with some cancers, there are lymphocytes that are capable of recognizing the tumor. However, they are obviously not functional since the cancers in these patients continue to grow. After removing the tumor, we have grown large numbers of the infiltrating lymphocytes in the laboratory. Reinfusion of these lymphocytes in patients with advanced melanoma has significantly reduced tumor volume in half of the patients. We are currently trying to improve these results by combining adoptive T-cell therapy with cancer vaccines.

This is an exciting time in cancer research with our increased understanding of the molecular nature of cancer and the immune response. Ultimately, our success will likely depend on the rational combination of appropriate chemotherapies, targeted therapies, immunotherapy, and the rapid translation of laboratory advances to the clinic.

For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.

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