Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD USA.
Hum Vaccin Immunother. 2013 Jan;9(1):219-21. doi: 10.4161/hv.22106. Epub 2012 Sep 20.
Personalized therapy is directed at obtaining maximal therapeutic effect on diseased tissue with minimal off-target side effects. Many classes of therapeutics have attempted to reach this ideal, only to fall well short. Therapeutic vaccines represent a novel class of therapies that can induce a dynamic immune response that, in theory, can continue to adapt and expand following initiation of vaccination. This adaptability, through epitope spreading or antigen cascade, can continuously refine a therapeutic immune response, making it more relevant to the patient's tumor. This active, dynamic, iterative process can continue long after the vaccine course has been completed. Recent clinical trials have provided further insight into the clinical activity of therapeutic vaccines, and offer guidance on clinical expectations following vaccine. The ongoing active sculpting of the immune response, along with the lack of significant side effects, uniquely positions therapeutic vaccines as perhaps the ultimate in personalized therapy.
个体化治疗旨在对病变组织产生最大的治疗效果,同时将非靶向副作用降至最低。许多治疗药物类别都试图达到这一理想状态,但都未能如愿。治疗性疫苗代表了一类新的治疗方法,它可以诱导一种动态的免疫反应,从理论上讲,这种反应在接种疫苗后可以继续适应和扩展。通过表位扩展或抗原级联反应,这种适应性可以不断完善治疗性免疫反应,使其更符合患者的肿瘤。这种主动、动态、迭代的过程可以在疫苗疗程完成后持续很长时间。最近的临床试验为治疗性疫苗的临床活性提供了进一步的了解,并为疫苗接种后的临床预期提供了指导。免疫反应的持续积极塑造,加上没有明显的副作用,使治疗性疫苗成为个性化治疗的终极选择。