Cancer vaccines as a targeted immunotherapy approach for breast cancer: an update of clinical evidence

ABSTRACT

Introduction

Breast cancer (BC) is the first common neoplastic malignancy and the second leading cause of death in women worldwide. Conventional treatments for BC are often associated with severe side effects and may even lead to late recurrence. For this reason, in recent years, cancer immunotherapy (e.g. cancer vaccines), a novel approach based on the specificity and amplification of acquired immune responses, has been considered as a potential candidate in particular to treat metastatic BC.

Areas covered

In this review, we summarize and discuss the recent development of therapeutic vaccines for BC, use of specific BC cellular antigens, antigen selection, and probable causes for their insufficient effectiveness.

Expert opinion

Despite development of several different BC vaccines strategies including protein/peptide, dendritic cell, and genetic vaccines, until now, no BC vaccine has been approved for clinical use. Most of the current BC vaccines themselves fail to bring clinical benefit to BC patients and are applied in combination with radiotherapy, chemotherapy, or targeted therapy. It is hoped that with advances in our knowledge about tumor microenvironment and the development of novel combination strategies, the tumor immunosuppressive mechanisms can be overcome and prolonged immunologic and effective antitumor response can be developed in patients.

KEYWORDS:

• Cancer immunotherapy
• breast cancer
• dendritic cell vaccines
• peptide-based vaccine
• DNA-based vaccine

Article highlights

• Tumor microenvironment and low antigenicity of breast cancer (BC) cells are the most important causes for BC immunotherapy failure.

• Combination of immunogenic cell death inducer and DC-based vaccines might improve the efficacy of BC immunotherapy.

• Personalized immunotherapy (e.g. individualized neoantigen vaccine) has a promising future in developing of BC vaccines.

• Co-administration of BC vaccines with immune checkpoints inhibitors have shown considerable success in preclinical and clinical studies.

• Better patient selection, improvement of antigen identification and selection, optimization of antigen delivery systems, and use of novel combination therapies must be considered in BC vaccine researches.

Declaration of interest

The author(s) have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have intellectual property on DC1 vaccine for treatment of cancer. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Author contributions

M. Abbaspour and V. Akbari conceived the idea for the manuscript, drafted the manuscript, and edited the final draft. Both authors had in put to the final draft of the manuscript and agree to its publication.

Additional information

Funding

This paper was funded by the Isfahan University of Medical Sciences (grant no. 198101).