Targeting the immune system in non-small-cell lung cancer: bridging the gap between promising concept and therapeutic reality. Review uri icon

Overview

abstract

  • Developing effective immunotherapy for lung cancer is a daunting but hugely attractive challenge. Until recently, non-small-cell lung cancer (NSCLC) was thought of as a nonimmunogenic tumor, but there is now evidence highlighting the integral role played by both inflammatory and immunologic responses in lung carcinogenesis. Despite recent encouraging preclinical and phase I/II data, there are a paucity of phase III trials showing a clear clinical benefit for vaccines in lung cancer. There are many difficulties to overcome before the development of a successful therapy. Perhaps a measurable immune response may not translate into a clinically meaningful or radiologic response. Patient selection may also be a problem for ongoing clinical studies. The majority of trials for lung cancer vaccines are focused on patients with an advanced stage of the disease; however, the ideal candidates may be patients with a lower tumor burden and stage I or II disease. Selecting the exact antigens to target is also difficult. It will likely require multiple epitopes of a diverse set of genes restricted to multiple haplotypes to generate a truly effective vaccine that is able to overcome the various immunologic escape mechanisms that tumors use. This review discusses the most promising active immunotherapy using protein/peptide vaccines, whole cell vaccines, and dendritic cell vaccines and examines current phase I and II clinical trial data on some novel nonspecific immunomodulating agents.

publication date

  • July 1, 2010

Research

keywords

  • Cancer Vaccines
  • Carcinoma, Non-Small-Cell Lung
  • Immunotherapy
  • Lung Neoplasms

Identity

PubMed Central ID

  • PMC3474196

Scopus Document Identifier

  • 77957114732

Digital Object Identifier (DOI)

  • 10.3816/CLC.2010.n.029

PubMed ID

  • 20630824

Additional Document Info

volume

  • 11

issue

  • 4