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Q J Med 1999; 92: 299-307
© 1999 Association of Physicians

Review

Vaccine therapy for cancer—fact or fiction?

T.R.J. Evans and S.B. Kaye

From the CRC Department of Medical Oncology, University of Glasgow, Glasgow, UK

Dr T.R.J. Evans, CRC Department of Medical Oncology, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD. e-mail: trjelv@udcf.gla.ac.uk


   Introduction
 
In the 1890s, William B. Coley started to treat cancer patients with inoculations of bacterial extracts (Coley's toxins) to activate general systemic immunity, some of which might be directed against the tumour.1,2 Subsequent efforts to enhance our understanding of the molecular basis of immune recognition and immune regulation of cancer cells have led to the identification of potential new targets on tumour cells, and the potential to create potent, specific cancer vaccines. In this review, we discuss the principles of tumour immunity, the tumour antigens that can be recognized by the immune system, the different types of vaccines that have been evaluated, and the potential clinical applications of these approaches.


   Principles of tumour immunity
 
Unlike most vaccines for infectious agents, the goal of cancer vaccination is therapeutic and this can be achieved by activating immune responses against tumour antigens. The immune response can be crudely divided into either antibody responses or T-cell responses. Antibodies . . . [Full Text of this Article]


   Tumour antigens
 
Unique tumour antigens
Shared tumour-specific antigens
Tumour-associated differentiation antigens (TADA)
Oncogene and tumour suppressor gene products
Virus-associated tumour antigens

   Vaccine design: cell-based or antigen-specific?
 

   Cancer vaccines: antigen-specific
 

   Cancer vaccines: potential clinical applications
 

   Acknowledgments
 

   References
 

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