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Tiwari A, Alcover K, Carpenter E, Thomas K, Krum J, Nissen A, Van Decar S, Smolinsky T, Valdera F, Vreeland T, Lacher M, Del Priore G, Williams W, Stojadinovic A, Peoples G, Clifton G. Utility of cell-based vaccines as cancer therapy: Systematic review and meta-analysis. Hum Vaccin Immunother 2024; 20:2323256. [PMID: 38544385 PMCID: PMC10984131 DOI: 10.1080/21645515.2024.2323256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
Cell-based therapeutic cancer vaccines use autologous patient-derived tumor cells, allogeneic cancer cell lines or autologous antigen presenting cells to mimic the natural immune process and stimulate an adaptive immune response against tumor antigens. The primary objective of this study is to perform a systematic literature review with an embedded meta-analysis of all published Phase 2 and 3 clinical trials of cell-based cancer vaccines in human subjects. The secondary objective of this study is to review trials demonstrating biological activity of cell-based cancer vaccines that could uncover additional hypotheses, which could be used in the design of future studies. We performed the systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The final review included 36 studies - 16 single-arm studies, and 20 controlled trials. Our systematic review of the existing literature revealed largely negative trials and our meta-analysis did not show evidence of clinical benefit from cell-based cancer-vaccines. However, as we looked beyond the stringent inclusion criteria of our systematic review, we identified significant examples of biological activity of cell-based cancer vaccines that are worth highlighting. In conclusion, the existing literature on cell-based cancer vaccines is highly variable in terms of cancer type, vaccine therapies and the clinical setting with no overall statistically significant clinical benefit, but there are individual successes that represent the promise of this approach. As cell-based vaccine technology continues to evolve, future studies can perhaps fulfill the potential that this exciting field of anti-cancer therapy holds.
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Affiliation(s)
- Ankur Tiwari
- Department of Surgery, University of Texas Health Science Center, San Antonio, TX, USA
| | - Karl Alcover
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Katryna Thomas
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
| | - Julia Krum
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
| | - Alexander Nissen
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
| | - Spencer Van Decar
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
| | - Todd Smolinsky
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
| | - Franklin Valdera
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
| | - Timothy Vreeland
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
| | | | | | | | | | | | - Guy Clifton
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
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Bozeman EN, He S, Shafizadeh Y, Selvaraj P. Therapeutic efficacy of PD-L1 blockade in a breast cancer model is enhanced by cellular vaccines expressing B7-1 and glycolipid-anchored IL-12. Hum Vaccin Immunother 2016; 12:421-30. [PMID: 26308597 DOI: 10.1080/21645515.2015.1076953] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Immunotherapeutic approaches have emerged as promising strategies to treat various cancers, including breast cancer. A single approach, however, is unlikely to effectively combat the complex, immune evasive strategies found within the tumor microenvironment, thus novel, effective combination treatments must be explored. In this study, we investigated the efficacy of a combination therapy consisting of PD-L1 immune checkpoint blockade and whole cell vaccination in a HER-2 positive mouse model of breast cancer. We demonstrate that tumorigenicity is completely abrogated when adjuvanted with immune stimulatory molecules (ISMs) B7-1 and a cell-surface anchored (GPI) form of IL-12 or GM-CSF. Irradiated cellular vaccines expressing the combination of adjuvants B7-1 and GPI-IL-12 completely inhibited tumor formation which was correlative with robust HER-2 specific CTL activity. However, in a therapeutic setting, both cellular vaccination and PD-L1 blockade induced only 10-20% tumor regression when administered alone but resulted in 50% tumor regression as a combination therapy. This protection was significantly hindered following CD4 or CD8 depletion indicating the essential role played by cellular immunity. Collectively, these pre-clinical studies provide a strong rationale for further investigation into the efficacy of combination therapy with tumor cell vaccines adjuvanted with membrane-anchored ISMs along with PD-L1 blockade for the treatment of breast cancer.
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Affiliation(s)
- Erica N Bozeman
- a Department of Pathology and Laboratory Medicine ; Emory University School of Medicine ; Atlanta , GA USA
| | - Sara He
- a Department of Pathology and Laboratory Medicine ; Emory University School of Medicine ; Atlanta , GA USA
| | - Yalda Shafizadeh
- a Department of Pathology and Laboratory Medicine ; Emory University School of Medicine ; Atlanta , GA USA
| | - Periasamy Selvaraj
- a Department of Pathology and Laboratory Medicine ; Emory University School of Medicine ; Atlanta , GA USA
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