The perfect personalized cancer therapy: cancer vaccines against neoantigens - PubMed (original) (raw)
Review
The perfect personalized cancer therapy: cancer vaccines against neoantigens
Luigi Aurisicchio et al. J Exp Clin Cancer Res. 2018.
Abstract
In the advent of Immune Checkpoint inhibitors (ICI) and of CAR-T adoptive T-cells, the new frontier in Oncology is Cancer Immunotherapy because of its ability to provide long term clinical benefit in metastatic disease in several solid and liquid tumor types. It is now clear that ICI acts by unmasking preexisting immune responses as well as by inducing de novo responses against tumor neoantigens. Thanks to theprogress made in genomics technologies and the evolution of bioinformatics, neoantigens represent ideal targets, due to their specific expression in cancer tissue and the potential lack of side effects. In this review, we discuss the promise of preclinical and clinical results with mutation-derived neoantigen cancer vaccines (NCVs) along with the current limitations from bioinformatics prediction to manufacturing an effective new therapeutic approach.
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Figures
Fig. 1
The pipeline of neoantigen cancer vaccine production, for mouse studies (left side and human studies (right side). 1. Tumor and normal tissue are collected and subjected to (2) exome sequencing and RNAseq analysis for the tumor samples. 3. expressed non-synonymous mutations are then further selected according to binding to predictive algorithms and incorporated in a vaccine vector or delivered as peptides with adjuvants
Fig. 2
Personalized NCV in the context of current immunotherapy, the three dimensions are defined by tumor infiltrating lymphocytes (TILs), mutational load (ML) and tumor heterogeneity (TH). Patients in the lower right panel (TIL−ML+TH+) may benefit from Neoantigen cancer vaccine (NCV) approach whereas patients in the upper right panel (TILs+ML+TH−) respond more to immune checkpoint inhibitors (ICI)
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