Breast Cancer Vaccines: New Insights

Abstract

Breast cancer (BC) is a persistent global challenge for its high frequency in women (although it seldom occurs in men), due to the large diffusion of risk factors and gene mutations, and for its peculiar biology and microenvironment. To date, BC can benefit from different therapeutic strategies involving surgery, ablation, chemotherapy, radiotherapy, and more specific approaches such as hormone therapy and the administration of various substances impairing cancer growth, aggressivity, and recurrence with different modalities. Despite these relatively wide chances, also used in combinatory protocols, relevant mortality and relapse rates, often associated with resistant phenotypes, stress the need for a personalized-medicine based on prompting the patient’s immune system (IS) against cancer cells. BC immunogenicity was latterly proven, so the whole immunotherapy field for BC is still at a very early stage. This immunotherapeutic approach exploits both the high specificity of adaptive immune response and the immunological memory. This review is focused on some of the majorly relevant BC vaccines available (NeuVax, AVX901, and INO-1400), providing a description of the more promising clinical trials. The efficacy of cancer vaccines highly depends on the patient’s IS, and a wide optimization is needed in terms of targets’ selection, drug design and combinations, dose finding, protocol structuring, and patients’ recruitment; moreover, new standards are being discussed for the outcome evaluation. However, early-phases excellent results suggest that the manipulation of the IS via specific vaccines is a highly attractive approach for BC.

The Role of Immune Cells in Breast Tissue and Immunotherapy for the Treatment of Breast Cancer

“…86 Given the presence of an immune infiltrate in stages as early as DCIS, strategies to boost the immune response to potential tumor antigens by vaccination have been explored in prevention, adjuvant, neoadjuvant and metastatic settings. 87 Additional efforts explore the use of tumor ablative strategies (ie, cryoablation, radiofrequency ablation, stereotactic radiation) for potential release of tumor-associated antigens in conjunction with checkpoint inhibitor monoclonal antibodies to increase response rates. 88,89 A recent review highlighted the ways that the field of breast cancer immuno-oncology is building on information about TIL phenotypes to branch into different promising avenues of research.…”

The Journey of in vivo Virus Engineered Dendritic Cells From Bench to Bedside: A Bumpy Road

“…Secondly, virus-like replicons have been generated from an attenuated strain of VEE with potential antineoplastic activity ( 118 , 119 , 120 ). This self-amplifying replicon was evaluated in a phase I clinical trial for its safety and efficacy to deliver HER2 and is termed AVX901 ( 121 ). More specifically 22 patients with HER2-overexpressing (breast) cancer were evaluated, alone or in combination with other HER2-targeted therapies such as trastuzumab.…”

Modeling Immune-Mediated Activations and Interactions in Breast Cancer Progression

“…The role of the immune system in controlling breast tumor progression has been studied by many authors [2][3][4][5][6] and significant development has been made in the treatment of breast cancer, especially with the growing use of cancer vaccines [7][8][9]. The breast cancer tumor microenvironment is composed of a variety of immune cells that can control or capture the malignant progression.…”

“…Currently, one approach in combating breast cancer progression is to use cancer vaccine that triggers the patient's immune system to identify the foreign antigens by stimulating cytotoxic T lymphocytes (CTL) [9][10][31][32][33]. The vaccination components consist of lymphocytes, which include: helper T lymphocytes (Th), dendritic cells (DC), macrophages, or reprogrammed oncolytic viruses [35][36][37].…”