“…In particular, keyhole limpet hemocyanin (KLH) has been shown to be the most effective carrier for TACAs (86), and KLH conjugates of GM2 for melanoma (27) as well as those of sTn for breast cancer (73) have both entered phase III clinical trials. However, the disappointing outcomes of these vaccine clinical trials, in terms of time-to-disease progression and overall survival, have driven the generation of several forms of fully synthetic carbohydrate vaccines, which have been shown to be immunogenic regardless of the use of a protein carrier or external adjuvant (6,13,22,76,176,194). Unfortunately, despite all efforts, TACA-based cancer vaccines have failed to induce sufficient T cell-mediated immune responses in cancer patients, and none has been approved for clinical use yet (64).…”