Therapeutic cancer vaccines.

The immunological bases of current approaches to therapeutic cancer vaccination (or 'vacci-treatment') have been established for a decade or longer. The new developments lie mostly in the lessons learnt from clinical testing of these approaches. Three lessons are particularly worthy of note. First, recently completed randomized Phase 3 trials suggest that vacci-treatment with autologous dendritic cells expressing prostatic acid phosphatase (for prostate cancer) or with autologous tumor-derived heat shock protein (gp96)-peptide complexes show promise in enhancing survival of cancer patients. These two approaches are undergoing further randomized clinical testing. Second, immunological monitoring of many clinical trials has failed to identify a surrogate marker for clinical outcomes. Finally, an increasing volume of literature suggests that protective immunity to human cancers is elicited by the mutated antigenic repertoire unique to each cancer.