Abstract
Simple SummaryTherapeutic vaccines are given to patients with cancer, as opposed to prophylactic vaccines given to a healthy population. The challenge for therapeutic oncological vaccines is to stimulate an immune T cell response against endogenous (or derived) antigens that is sufficiently potent to induce cytotoxic activity and broad enough to take tumor heterogeneity into account. The purpose of this article is to provide an updated review of the prophylactic and therapeutic vaccines that target viral or non-viral antigens, particularly in head and neck cancers.In 2019, the FDA approved pembrolizumab, a monoclonal antibody targeting PD-1, for the first-line treatment of recurrent or metastatic head and neck cancers, despite only a limited number of patients benefiting from the treatment. Promising effects of therapeutic vaccination led the FDA to approve the use of the first therapeutic vaccine in prostate cancer in 2010. Research in the field of therapeutic vaccination, including possible synergistic effects with anti-PD(L)1 treatments, is evolving each year, and many vaccines are in pre-clinical and clinical studies. The aim of this review article is to discuss vaccines as a new therapeutic strategy, particularly in the field of head and neck cancers. Different vaccination technologies are discussed, as well as the results of the first clinical trials in HPV-positive, HPV-negative, and EBV-induced head and neck cancers.
Highlights
Immune checkpoint inhibitors and targeted therapies are a major oncological breakthrough and are currently approved by the U.S Food and Drug Administration (FDA) as treatment options for several cancers
The expression of immunomodulating enzymes, such as indoleamine-2,3-dioxygenase 1 (IDO-1) by cancer cells and other peri-tumoral cells, can alter host dendritic cells (DCs) differentiation, maturation, and functionality, and inhibit the activation of effector T-cells, promote the transformation of naïve T cells into regulatory T cells (Tregs), and induce a peritumoral immunotolerant environment towards cancer cells [30,31]. Another potential factor is that studies investigating DC-based vaccines have been performed in patients with multiresistant cancers who have already benefited from several lines of treatment, and this may underestimate the biological activity and efficacy of this type of treatment
The results suggest that this vaccine should be investigated to prevent relapse and as combination therapy with anti-programmed death (PD)-1 immunotherapies [48]
Summary
Immune checkpoint inhibitors and targeted therapies are a major oncological breakthrough and are currently approved by the U.S Food and Drug Administration (FDA) as treatment options for several cancers. Patients with “hot tumors” seem to currently have a more favorable outcome These tumors are defined as being in an inflammatory microenvironment with a high immune gene expression signature, high level of tumor-invasive T-lymphocytes (TIL), a strong tumor expression of PD-ligand(L), and a high mutational or neoantigen burden. Several studies have highlighted that HNSCC with a high level of TIL invasion, or high expression of immune-related genes, has a better overall survival, disease-specific survival, and disease-free survival [5,6,7] These non-independent markers differ from “cold tumors” that respond poorly to ICIs and are associated with poor survival [8]. The purpose of this article is to provide an updated review on vaccine-based therapies, in head and neck cancers
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