Abstract
BackgroundThe historical basis and contemporary evidence for the use of immune strategies for prevention of malignancies are reviewed. Emphasis is focussed on the Febrile Infections and Melanoma (FEBIM) study on melanoma and on malignancies that seem to be related to an overexpression of human endogenous retrovirus K (HERV-K).DiscussionIt is claimed that, as a result of recent observational studies, measures for prevention of some malignancies such as melanoma and certain forms of leukaemia are already at hand: vaccination with Bacille Calmette-Guérin (BCG) of new-borns and vaccination with the yellow fever 17D (YFV) vaccine of adults. While the evidence of their benefit for prevention of malignancies requires substantiation, the observations that vaccinations with BCG and/or vaccinia early in life improved the outcome of patients after surgical therapy of melanoma are of practical relevance as the survival advantage conferred by prior vaccination is greater than any contemporary adjuvant therapy.SummaryThe reviewed findings open a debate as to whether controlled vaccination studies should be conducted in patients and/or regions for whom/where they are needed most urgently. A study proposal is made and discussed. If protection is confirmed, the development of novel recombinant vaccines with wider ranges of protection based, most likely, on BCG, YFV or vaccinia, could be attempted.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2407-14-595) contains supplementary material, which is available to authorized users.
Highlights
The historical basis and contemporary evidence for the use of immune strategies for prevention of malignancies are reviewed
Summary: The reviewed findings open a debate as to whether controlled vaccination studies should be conducted in patients and/or regions for whom/where they are needed most urgently
A subsequent study report included the history of vaccinations and demonstrated protection with an odds ratio of risk of 0.4 (95% confidence interval 0.18-0.85) in those vaccinated with Bacille Calmette-Guérin (BCG) alone, 0.6 in those vaccinated with vaccinia alone and 0.41 in those receiving both vaccines [81]
Summary
Prior claims that BCG vaccination affords protection against certain malignancies have been reviewed, together with the results of the more recent FEBIM study. The more recent studies including those by the FEBIM group suggest that measures for prevention of some malignancies such as melanoma and some forms of leukaemia are already at hand: BCG vaccination of new-borns and (for melanoma) YFV of adults. We concede that the evidence of their benefit for prevention of malignancies needs to be strengthened by further studies and, as some other cancers express HERV-K epitopes [84,89,90,111,115], these could likewise be the subjects of further studies Such studies could well pave the way to the development of recombinant vaccines with improved and extended properties and these might well be based on YFV, mycobacterial and/or vaccinia vaccines
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