Tumour vaccines:: a new immunotherapeutic approach in oncology

Substantial progress has been made in vaccine development in recent years for the treatment of malignant diseases. New technologies have fostered the identification of potentially immunogenic tumour antigens that can be used to activate the patient's immune system to specifically recognize and destroy human tumour cells. More detailed insights into the process of intracellular protein degradation, processing and cell surface presentation have allowed immunogenic peptide domains to be identified that can be used in vaccine trials. Still a matter of intensive debate is the question of the most optimal presentation of tumour-derived proteins or peptides to the immune system to achieve a maximum response. In this area, major progress has been made by using dendritic cell or even naked DNA-based vaccines. The generation of new tools such as HLA-tetramer complexes now allows researchers to monitor more closely the expansion of peptide-specific T cells under the process of vaccination. On the basis of these advances, a couple of vaccine trials have been performed that have increased our knowledge of vaccine development and provided indications that the concept of tumour-specific vaccination might be valid. However, we are still at the beginning of this process and should always remember that only well-designed, prospective clinical trials can define the optimal use of tumour vaccines in oncology.