Vaccination Immunotherapy — An Update

Abstract

Renal cell carcinoma is often regarded as an "immunogenic tumor". Organ-confined tumors are best treated by operative removal. Adjuvant strategies, however, may improve the outcome after operative therapy. Recently, a phase-III trial using an autologous renal tumor cell vaccine was able to demonstrate a reduction of the risk of progression in patients after radical nephrectomy for renal cell carcinoma larger than 2.5 cm. These results were achieved with minimal side effects. Patients with metastases have a poor prognosis. Thirty years ago autologous tumor cell vaccination resulted in remissions in a small number of patients. Almost all vaccination reports focus on patients with metastatic renal cell carcinoma. These reports differ considerably in their modes of preparation, stimulation, application route and intervals and other relevant parameters. More important, clinical response is limited in most studies. For metastatic renal cell carcinoma none of the various vaccination approaches are being currently investigated in phase-III trials. Ongoing efforts focus on development of more powerful vaccines. This review summarizes vaccination approaches for renal cell carcinomas published in the past 4 years.

Grundlagen der systemischen Therapie

“…Hierbei handelte es sich um Juckreiz oder Hautrötungen von geringem oder mittlerem Schweregrad (WHO Grad 1 und 2; Jocham et al 2004). Die meisten Arbeiten zu Vakzinetherapien beim Nierenzellkarzinom wurden allerdings bei Patienten mit Metastasen vorgenommen (Doehn et al 2004). Die amerikanische Firma Antigenics hat im Jahr 2001 eine Phase-III-Studie zur adjuvanten Therapie des Nierenzellkarzinoms mittels einer autologen Hitzeschockproteinvakzine (HSPPC-96, Oncophage) nach Nephrektomie versus alleiniger Nephrektomie initiiert (Wood et al 2008).…”

Tumor heterogeneity as a rationale for a multi-epitope approach in an autologous renal cell cancer tumor vaccine

“…The overall image is still inconsistent and requires an immunochemical analysis of RCCs as the basis for comparing the later analysis of the immune response against RCC after therapy with a cell lysate-based tumor vaccine. 14 The “best” marker so far is CA-IX 15 , 16 found mostly on tumors of the clear cell type, which represent ~75% of all RCC. 17 Nonetheless, this marker is neither present in all tumor cells nor throughout the whole tumor.…”