Next-generation cancer vaccines and emerging immunotherapy combinations

Zinc Ion-Coordinated Sericin Calcium Phosphate Nanovaccines Induce Hyperactive Dendritic Cells and Synergistic Activation of T Cells for Cancer Immunotherapy

Peptide-based neoantigen vaccines are promising cancer immunotherapy strategies because of their capability to induce durable tumor-specific immune responses. However, insufficient neoantigen-specific T-lymphocyte activation greatly limits their clinical efficacy. Here, we developed sericin-coordinated zinc ion-modified calcium phosphate (CP) nanovaccines that codeliver tumor antigen peptides and a Toll-like receptor 9 agonist (SZCP/APs-CpG) for potentiating antigen-specific T cell immunity. SZCP/APs-CpG nanovaccines could yield efficient codelivery of antigen peptides and adjuvants to dendritic cells (DCs) in draining lymph nodes (dLNs), induce hyperactive DCs depending on the inflammasome-dependent interleukin-1β secretion, and coordinate the released Zn2+-induced T cell activation to elicit robust and durable antigen-specific T cell immune responses. Vaccination with SZCP/APs-CpG exhibited potent anticancer efficacy and superior safety in multiple murine cancer models and significantly protected against B16-OVA tumor rechallenge and eradicated orthotopic colon cancer in mice when combined with immune checkpoint blockade. Thus, our work presents an efficient and versatile nanovaccine platform for boosting antigen-specific T cell activation for cancer immunotherapy.

Immuno-oncology in the daily practice

PURPOSE OF REVIEW

Immune checkpoint inhibitors (ICI) have become an integral part of oncology treatment. ICI currently has approval for more than thirty tumor types with proven efficacy. However, ICI can expose patients to inflammatory side effects, such as immuno-related adverse events (irAE). The spectrum of irAE and the time to onset can be very broad, sometimes leading to the patient's death.Additionally, ICI could be associated with chronic or long-term adverse events that impact quality of life. The expansion of the indications for immunotherapy in the early adjuvant and neoadjuvant stages is altering the benefit-risk balance of these therapies.Furthermore, the combination of immunotherapies with other oncology treatments makes the interpretation of adverse events difficult.To date, no predictive factors have been identified in routine practice to identify patients at risk of developing serious toxicity.

RECENT FINDINGS

This has led us to develop a patient care pathway dedicated to the management of these toxicities, enabling early detection of irAE to improve outcomes.

SUMMARY

We have presented a novel care pathway based on a clinical evaluation, encompassing a daily hospital devoted to the management of toxicities, an iTox multidisciplinary board, and a pharmacovigilance database. This pathway involves a translational research program.The toxicity day hospital allowed us to care for patients at an early stage of an adverse event and to establish whether anticancer treatment was responsible for the onset of symptoms and/or biological abnormalities.The objective of this pathway is to enhance the quality of life and compliance of oncology treatment, while minimizing the necessity for unscheduled care.

Cancer vaccines: platforms and current progress

Cancer vaccines, crucial in the immunotherapeutic landscape, are bifurcated into preventive and therapeutic types, both integral to combating oncogenesis. Preventive cancer vaccines, like those against HPV and HBV, reduce the incidence of virus-associated cancers, while therapeutic cancer vaccines aim to activate dendritic cells and cytotoxic T lymphocytes for durable anti-tumor immunity. Recent advancements in vaccine platforms, such as synthetic peptides, mRNA, DNA, cellular, and nano-vaccines, have enhanced antigen presentation and immune activation. Despite the US Food and Drug Administration approval for several vaccines, the full therapeutic potential remains unrealized due to challenges such as antigen selection, tumor-mediated immunosuppression, and optimization of delivery systems. This review provides a comprehensive analysis of the aims and implications of preventive and therapeutic cancer vaccine, the innovative discovery of neoantigens enhancing vaccine specificity, and the latest strides in vaccine delivery platforms. It also critically evaluates the role of adjuvants in enhancing immunogenicity and mitigating the immunosuppressive tumor microenvironment. The review further examines the synergistic potential of combining cancer vaccines with other therapies, such as chemotherapy, radiotherapy, and immune checkpoint inhibitors, to improve therapeutic outcomes. Overcoming barriers such as effective antigen identification, immunosuppressive microenvironments, and adverse effects is critical for advancing vaccine development. By addressing these challenges, cancer vaccines can offer significant improvements in patient outcomes and broaden the scope of personalized cancer immunotherapy.

A KIF20A-based thermosensitive hydrogel vaccine effectively potentiates immune checkpoint blockade therapy for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a highly prevalent malignancy with limited treatment efficacy despite advances in immune checkpoint blockade (ICB) therapy. The inherently weak immune responses in HCC necessitate novel strategies to improve anti-tumor immunity and synergize with ICB therapy. Kinesin family member 20A (KIF20A) is a tumor-associated antigen (TAA) overexpressed in HCC, and it could be a promising target for vaccine development. This study confirmed KIF20A as a promising immunogenic antigen through transcriptomic mRNA sequencing analysis in the context of HCC. Therefore, we developed a thermosensitive hydrogel vaccine formulation (K/RLip@Gel) to optimize antigen delivery while enabling sustained in vivo release. The vaccine efficiently elicited robust immune responses by activating DCs and T cells. Moreover, K/RLip@Gel improved the therapeutic efficacy of PD-L1 blockade in subcutaneous and orthotopic cell-derived xenograft (CDX) models, along with immune-humanized patient-derived xenograft (PDX) HCC models, which was evidenced by improved maturation of DCs and elevated infiltration and activation of CD8+ T cells. These findings highlight the potential of KIF20A-based vaccines to synergistically improve ICB therapy outcomes in HCC, providing a promising approach for enhancing anti-tumor immunity and improving clinical outcomes.

Progress in modifying and delivering mRNA therapies for cancer immunotherapy

Advancements in mRNA-based therapeutics have greatly enhanced cancer immunotherapy by using the immune system to specifically target and eradicate cancer cells. There has been notable advancement in tailoring and administering mRNA to treat cancer. Codon optimization, chemical alterations, and sequence manipulation are complex design methodologies employed in the production of mRNA vaccines and treatments. The goal is to improve the ability of the chemicals to stimulate an immune response, increase their ability to be translated into practical applications, and boost their stability. Lipid nanoparticles (LNPs) are currently the most efficient means of delivering mRNA because they can withstand degradation, enhance cellular uptake, and facilitate endosomal escape. Scientists are currently investigating the possibility of using alternate methods of delivering substances, including as exosomes, lipoplexes, and polymeric nanoparticles, to enhance the ability to target specific tissues and minimize unwanted negative consequences. In addition, recent clinical trials and preclinical investigations have demonstrated encouraging findings in terms of the advancement of strong anti-tumor immune responses, long-lasting tumor shrinkage, and enhanced patient outcomes. The remaining challenges involve optimizing the equilibrium between tolerance and immunological activation, addressing systemic toxicity, and expanding manufacturing techniques. The upcoming study seeks to improve the design and dissemination of mRNA, include it in combination drugs, and investigate its therapeutic uses outside cancer. The advancement in cancer treatment represents a change in the current approach, highlighting the significant impact of mRNA technology in revolutionizing immunotherapy and enabling tailored cancer treatments.