No abstract

There has been renewed interest in developing vaccine and immunotherapy for the treatment of cancer. The oncofetal antigen, 5T4, is a surface glycoprotein that is expressed on a variety of human adenocarcinomas but rarely on normal tissue. 5T4 plays an important role in tumor progression and metastasis. The expression patterns and functional role in the metastatic process suggest that 5T4 is a good target for vaccine development. A modified vaccinia virus Ankara (MVA) encoding human 5T4 (designated TroVax) demonstrated therapeutic effects in murine tumor models and human T cells recognized 5T4 epitopes in an HLA-restricted manner. The TroVax vaccine has subsequently been evaluated in clinical trials targeting patients with colorectal cancer, renal cell carcinoma and hormone refractory prostate cancer. Herein, we review the results of these clinical studies, discuss the lessons learned through these trials and provide some insight into the future development of TroVax as a cancer vaccine.

Background Intraoperative near‐infrared imaging (NIFI) of parathyroid glands (PG) by first‐generation technology had limited image quality and depth penetration. Second‐generation NIFI has recently been introduced. Our aim was to compare (1) capability to detect PG and (2) image quality between older and newer technologies. Methods Accurately detecting PG, as well as, quality of autofluorescence (AF) was compared between an older charge‐coupled device (CCD) camera and a newer complementary metal‐oxide semiconductor (CMOS). χ2, t test, and analysis of variance were used for analysis. Results There were 300 patients who underwent parathyroidectomy (PTX) and/or thyroidectomy (THY) with NIFI, 200 with CCD, and 100 with CMOS. Although both NIFI technologies detected >94% of PG, CMOS was superior to CCD. Comparing AF quality, mean pixel intensity of PG compared with the background was higher with CMOS compared with CCD. When comparing PG detected by NIFI before visual identification by a surgeon, both CCD and CMOS had similar results (25% vs. 22%; p = .3). Conclusion Both NIFI cameras were excellent at detecting PG. Second‐generation NIFI (CMOS) displayed higher detection rates and AF intensity. Although surgeons identified majority of PG before NIFI detection, 25% of PG were identified with NIFI first, suggesting future advancements of this technology may expand its applications during parathyroid/thyroid operations.

No abstract

No abstract