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Vaccination against Cancer or Infectious Agents during Checkpoint Inhibitor Therapy. Vaccines (Basel) 2021; 9:vaccines9121396. [PMID: 34960142 PMCID: PMC8706349 DOI: 10.3390/vaccines9121396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/14/2021] [Accepted: 11/18/2021] [Indexed: 12/19/2022] Open
Abstract
The use of immune checkpoint inhibitors (ICI) has substantially increased the overall survival of cancer patients and has revolutionized the therapeutic situation in oncology. However, not all patients and cancer types respond to ICI, or become resistant over time. Combining ICIs with therapeutic cancer vaccines is a promising option as vaccination may help to overcome resistance to immunotherapies while immunotherapies may increase immune responses to the particular cancer vaccine by reinvigorating exhausted T cells. Thus, it would be possible to reprogram a response with appropriate vaccines, using a particular cancer antigen and a corresponding ICI. Target populations include currently untreatable cancer patients or those who receive treatment regimens with high risk of serious side effects. In addition, with the increased use of ICI in clinical practice, questions arise regarding safety and efficacy of administration of conventional vaccines, such as influenza or COVID-19 vaccines, during active ICI treatment. This review discusses the main principles of prophylactic and therapeutic cancer vaccines, the potential impact on combining therapeutic cancer vaccines with ICI, and briefly summarizes the current knowledge of safety and effectiveness of influenza and COVID-19 vaccines in ICI-treated patients.
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Chiu LC, Lin SM, Lo YL, Kuo SCH, Yang CT, Hsu PC. Immunotherapy and Vaccination in Surgically Resectable Non-Small Cell Lung Cancer (NSCLC). Vaccines (Basel) 2021; 9:689. [PMID: 34201650 PMCID: PMC8310081 DOI: 10.3390/vaccines9070689] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 12/15/2022] Open
Abstract
Early-stage NSCLC (stages I and II, and some IIIA diseases) accounts for approximately 30% of non-small cell lung cancer (NSCLC) cases, with surgery being its main treatment modality. The risk of disease recurrence and cancer-related death, however, remains high among NSCLC patients after complete surgical resection. In previous studies on the long-term follow-up of post-operative NSCLC, the results showed that the five-year survival rate was about 65% for stage IB and about 35% for stage IIIA diseases. Platinum-based chemotherapy with or without radiation therapy has been used as a neoadjuvant therapy or post-operative adjuvant therapy in NSCLC, but the improvement of survival is limited. Immune checkpoint inhibitors (ICIs) have effectively improved the 5-year survival of advanced NSCLC patients. Cancer vaccination has also been explored and used in the prevention of cancer or reducing disease recurrence in resected NSCLC. Here, we review studies that have focused on the use of immunotherapies (i.e., ICIs and vaccination) in surgically resectable NSCLC. We present the results of completed clinical trials that have used ICIs as neoadjuvant therapies in pre-operative NSCLC. Ongoing clinical trials investigating ICIs as neoadjuvant and adjuvant therapies are also summarized.
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Affiliation(s)
- Li-Chung Chiu
- Division of Thoracic Medicine, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan; (L.-C.C.); (S.-M.L.); (Y.-L.L.); (S.C.-H.K.); (C.-T.Y.)
- Department of Thoracic Medicine, New Taipei Municipal Tu Cheng Hospital, New Taipei City 23652, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Shu-Min Lin
- Division of Thoracic Medicine, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan; (L.-C.C.); (S.-M.L.); (Y.-L.L.); (S.C.-H.K.); (C.-T.Y.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Yu-Lun Lo
- Division of Thoracic Medicine, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan; (L.-C.C.); (S.-M.L.); (Y.-L.L.); (S.C.-H.K.); (C.-T.Y.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Scott Chih-Hsi Kuo
- Division of Thoracic Medicine, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan; (L.-C.C.); (S.-M.L.); (Y.-L.L.); (S.C.-H.K.); (C.-T.Y.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Cheng-Ta Yang
- Division of Thoracic Medicine, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan; (L.-C.C.); (S.-M.L.); (Y.-L.L.); (S.C.-H.K.); (C.-T.Y.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Internal Medicine, Taoyuan Chang Gung Memorial Hospital, Taoyuan City 33378, Taiwan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Ping-Chih Hsu
- Division of Thoracic Medicine, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan; (L.-C.C.); (S.-M.L.); (Y.-L.L.); (S.C.-H.K.); (C.-T.Y.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
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Crombet Ramos T, Santos Morales O, Dy GK, León Monzón K, Lage Dávila A. The Position of EGF Deprivation in the Management of Advanced Non-Small Cell Lung Cancer. Front Oncol 2021; 11:639745. [PMID: 34211836 PMCID: PMC8240591 DOI: 10.3389/fonc.2021.639745] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/17/2021] [Indexed: 12/22/2022] Open
Abstract
Advanced non-small cell lung cancer (NSCLC) has faced a therapeutic revolution with the advent of tyrosine kinase inhibitors (TKIs) and immune checkpoints inhibitors (ICIs) approved for first and subsequent therapies. CIMAvax-EGF is a chemical conjugate between human-recombinant EGF and P64, a recombinant protein from Neisseria meningitides, which induces neutralizing antibodies against EGF. In the last 15 years, it has been extensively evaluated in advanced NSCLC patients. CIMAvax-EGF is safe, even after extended use, and able to keep EGF serum concentration below detectable levels. In a randomized phase III study, CIMAvax-EGF increased median overall survival of advanced NSCLC patients with at least stable disease after front-line chemotherapy. Patients bearing squamous-cell or adenocarcinomas and serum EGF concentration above 870 pg/ml had better survival compared to control patients treated with best supportive care as maintenance, confirming tumors’ sensitivity to the EGF depletion. This manuscript reviews the state-of-the-art NSCLC therapy and proposes the most promising scenarios for evaluating CIMAvax-EGF, particularly in combination with TKIs or ICIs. We hypothesize that the optimal combination of CIMAvax-EGF with established therapies can further contribute to transform advanced cancer into a manageable chronic disease, compatible with years of good quality of life.
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Affiliation(s)
| | | | - Grace K Dy
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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