Sobre el futuro de la vacuna contra el melanoma

Author: Stephen John Ralph,1
Source: American Journal of Clinical Dermatology, Volume 8, Number 3, 2007, pp. 123-141(19)
Abstract:
Currently, cancer vaccine therapy for melanoma has a 2-fold focus.

On the one hand, advances have been aimed at improving the effectiveness of melanoma vaccines based on a greater understanding of melanoma tumor cell biology. On the other hand, there is increasing evidence that the immune system, our defense against tumors, also inadvertently plays a supportive role in promoting the development and progression of tumors. Hence, two opposing forces `hanging in the balance' dictate patients' responses to melanoma: tumor cell biology and the status of the immune system. Recent developments in our understanding of both of these aspects have provided new leads and insights for novel ways to improve vaccine design and add to the melanoma vaccine armory. As the focus of immunotherapy shifts its aim towards the tumor microenvironment, we are now developing the ability to program the immune responses raised by vaccination against melanoma. The aim here is to prevent myeloid and regulatory T-cell-mediated immune suppression as well as to counteract tumor-derived factors capable of suppressing immune responses. A redirected strategy for vaccine immunotherapy is proposed based on our greater understanding of tumor immunity.

Using a combination therapy of immune-potentiating melanoma vaccines together with adjuvants for overcoming the immunosuppressive forces will allow us to activate protective immunity against melanoma. Other cancer vaccines (i.e. colon or renal) are already offering reasons for hope and expectation that vaccine immunotherapy will also produce successful outcomes for patients with melanoma.

Comentarios: actualmente la vacuna contra el melanoma tiene dos enfoques: a) mejorar la efectividad de la vacuna del melanoma basado en una mejor comprensión de la biología celular del melanoma, por otro lado b) aumentar la evidencia que nuestro sistema inmunológico juega un papel favorable promoviendo el desarrollo y la progresión del tumor. Del equilibrio de estas dos fuerzas contrarias resulta la respuesta del paciente: la biología celular del tumor y del sistema inmunológico. Una terapia combinada usando vacunas con potencial inmune de melanoma más un adyuvante para superar las inmunosupresión nos permitirá activar el sistema de inmunidad proteccionista contar el melanoma. Ya hay evidencia de otras vacunas contar otros tipos de cánceres que están siendo efectiva bajo este tipo de orientación.