13 research outputs found

    Strategies for Cancer Vaccine Development

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    Treating cancer with vaccines has been a challenging field of investigation since the 1950s. Over the years, the lack of effective active immunotherapies has led to the development of numerous novel strategies. However, the use of therapeutic cancer vaccines may be on the verge of becoming an effective modality. Recent phase II/III clinical trials have achieved hopeful results in terms of overall survival. Yet despite these encouraging successes, in general, very little is known about the basic immunological mechanisms involved in vaccine immunotherapy. Gaining a better understanding of the mechanisms that govern the specific immune responses (i.e., cytotoxic T lymphocytes, CD4 T helper cells, T regulatory cells, cells of innate immunity, tumor escape mechanisms) elicited by each of the various vaccine platforms should be a concern of cancer vaccine clinical trials, along with clinical benefits. This review focuses on current strategies employed by recent clinical trials of therapeutic cancer vaccines and analyzes them both clinically and immunologically

    Adjuvant capecitabine in triple negative breast cancer patients with residual disease after neoadjuvant treatment: real-world evidence from CaRe, a multicentric, observational study

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    Background: In triple negative breast cancer patients treated with neoadjuvant chemotherapy, residual disease at surgery is the most relevant unfavorable prognostic factor. Current guidelines consider the use of adjuvant capecitabine, based on the results of the randomized CREATE-X study, carried out in Asian patients and including a small subset of triple negative tumors. Thus far, evidence on Caucasian patients is limited, and no real-world data are available. Methods: We carried out a multicenter, observational study, involving 44 oncologic centres. Triple negative breast cancer patients with residual disease, treated with adjuvant capecitabine from January 2017 through June 2021, were recruited. We primarily focused on treatment tolerability, with toxicity being reported as potential cause of treatment discontinuation. Secondarily, we assessed effectiveness in the overall study population and in a subset having a minimum follow-up of 2 years. Results: Overall, 270 patients were retrospectively identified. The 50.4% of the patients had residual node positive disease, 7.8% and 81.9% had large or G3 residual tumor, respectively, and 80.4% a Ki-67 >20%. Toxicity-related treatment discontinuation was observed only in 10.4% of the patients. In the whole population, at a median follow-up of 15 months, 2-year disease-free survival was 62%, 2 and 3-year overall survival 84.0% and 76.2%, respectively. In 129 patients with a median follow-up of 25 months, 2-year disease-free survival was 43.4%, 2 and 3-year overall survival 78.0% and 70.8%, respectively. Six or more cycles of capecitabine were associated with more favourable outcomes compared with less than six cycles. Conclusion: The CaRe study shows an unexpectedly good tolerance of adjuvant capecitabine in a real-world setting, although effectiveness appears to be lower than that observed in the CREATE-X study. Methodological differences between the two studies impose significant limits to comparability concerning effectiveness, and strongly invite further research

    The Consequence of Immune Suppressive Cells in the Use of Therapeutic Cancer Vaccines and Their Importance in Immune Monitoring

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    Evaluating the number, phenotypic characteristics, and function of immunosuppressive cells in the tumor microenvironment and peripheral blood could elucidate the antitumor immune response and provide information to evaluate the efficacy of cancer vaccines. Further studies are needed to evaluate the correlation between changes in immunosuppressive cells and clinical outcomes of patients in cancer vaccine clinical trials. This paper focuses on the role of T-regulatory cells, myeloid-derived suppressor cells, and tumor-associated macrophages in cancer and cancer immunotherapy and their role in immune monitoring

    Maturation of human dendritic cells with Saccharomyces cerevisiae (yeast) reduces the number and function of regulatory T cells and enhances the ratio of antigen-specific effectors to regulatory T cells

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    I denna rapport presenteras det modellsystem som SMHI byggt upp för att beskriva miljötillstĂ„ndet i kustvattenomrĂ„den. I rapporten beskrivs kustzonssystemets olika anvĂ€ndningsomrĂ„den, systemets uppbyggnad och behov av indata. Rapporten har tagits fram inom ett projektarbete som LĂ€nsstyrelsen Östergötland och SMHI utfört pĂ„ uppdrag av NaturvĂ„rdsverket (NV Dnr 721-2732-02Mm).Kustzonssystemet Ă€r speciellt anpassat för berĂ€kning av eutrofieringstillstĂ„ndet i kustvattenbassĂ€nger. Systemet finns uppsatt för Hanöbukten, Östergötlands kustvatten och norra Bohuskusten. I modellsystemet indelas kustomrĂ„dena i bassĂ€nger med en meter tjocka sikt i djupled. VattenavgrĂ€nsningarna (oftast sund) mellan bassĂ€ngerna beskrivs geometriskt och omrĂ„den med tillrinning till olika delar av kusten definieras. I modellen berĂ€knas flöden av vatten och Ă€mnen till och mellan bassĂ€ngerna. Flödena skiktas in pĂ„ olika djup i bassĂ€ngerna beroende vattnets tĂ€thet, som huvudsakligen beror pĂ„ salthalten. Modellen berĂ€knar nya tillstĂ„ndsvariabler med korta tidsintervall för varje definierat djupskikt. Begreppet kustzonssystemet innefattar Ă€ven modeller och system för produktion av indata till kustzonsmodellen och system för presentation av resultat frĂ„n kustzonsmodellen.I den senaste uppsĂ€ttningen av kustzonssystemet (Norra Bohuskusten) berĂ€knas miljötillstĂ„ndet i 30 kopplade bassĂ€nger. För varje bassĂ€ng och varje dygn samt för en tidsperiod pĂ„ 10-15 Ă„r berĂ€knas temperatur, salthalt, syrgashalt, kvĂ€vefraktioner, fosforfraktioner, klorofyll, vĂ€xtplankton, djurplankton och detritus. Modellen har god vertikal upplösning. Upp till 156 djupskikt har definierats i befintliga modelluppsĂ€ttningar.Kustzonssystemet kan anvĂ€ndas i miljöövervakning och vid uppföljning av miljömĂ„l. Inom miljöövervakningen kan modellberĂ€knade resultat anvĂ€ndas för att ge en heltĂ€ckande bild av eutrofieringstillstĂ„ndet i ett kustvattenomrĂ„de. I arbete enligt vattendirektivet bedöms modellsystemet vara tillĂ€mpbart i samband med karaktĂ€risering av vattenförekomster. Systemet bedöms vara speciellt anvĂ€ndbart vid beskrivning av pĂ„verkan och för berĂ€kning av scenarier med koppling till miljömĂ„l och effekter av Ă„tgĂ€rder.Kustzonssystemet Ă€r framtaget för anvĂ€ndning vid arbete med eutrofieringsfrĂ„gor men den fysikaliska delen av systemet kan köras utan att den biologiska modellen Ă€r inkopplad. Den typen av berĂ€kningar ger information om salthalt, temperatur, islĂ€ggning, vattenomsĂ€ttning och vattenutbyten mellan bassĂ€nger.Kustzonssystemet bör göras mer tillĂ€mpbart och rationellt för körning av scenarier pĂ„ regional skala genom att system för s.k. TRK-berĂ€kningar (tillrinning, retention och kĂ€llfördelning i avrinningsomrĂ„den) (se Brandt & Ejhed, 2002) tas fram med finare geografisk upplösning. Mer information om tillĂ€mpningar av modellen finns i kapitel 5 och 6. Exempel pĂ„ grafisk redovisning av resultat finns i figurerna 3-6.I rapportens avsnitt 7 beskrivs översiktligt hur kustzonssystemet byggs upp. Beskrivningen Ă€r nĂ„got mer utförlig nĂ€r det gĂ€ller den information om utslĂ€pp frĂ„n punktkĂ€llor som behövs vid modellsystemets uppbyggnad. Denna information Ă€r nĂ€mligen viktig för tillĂ€mpningen av kustzonsmodellen och det Ă€r information som inte Ă€r lĂ€ttillgĂ€nglig för modellbyggaren.I slutet av rapporten finns ett förslag pĂ„ ytterligare 8 kustomrĂ„den för framtida implementering av kustzonssystemet. Förslaget Ă€r baserat pĂ„ en prioritering av kustomrĂ„den med sammanhĂ€ngande skĂ€rgĂ„rd. Dessutom bygger förslaget pĂ„ antagandet att varje omrĂ„de omfattas av ca 30 bassĂ€nger

    Effect of Talactoferrin Alfa on the Immune System in Adults With Non‐Small Cell Lung Cancer

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    BACKGROUND. Talactoferrin alfa (talactoferrin), an agent with immune-stimulating properties, has demonstrated safety and preliminary efficacy in clinical trials. METHODS. Ten patients (five males and five females) with stage IV non-small cell lung cancer (NSCLC) in a single-arm pilot study received orally administered talactoferrin (1.5 g, b.i.d.) for up to 24 weeks. Radiographic and immunologic studies were performed at baseline and at weeks 6 and 12. Circulating immune cells (natural killer cells [NKCs], CD4(+), CD8(+), and regulatory T cells) and systemic cytokine levels were measured to assess immune response. RESULTS. Patients enrolled in the study had received a median of four prior chemotherapy regimens, and all patients were symptomatic. Talactoferrin was well tolerated, with no grade 3 or 4 toxicities. Median time to progression (TTP) and overall survival were 6 weeks and 14.5 weeks, respectively. The four patients with ≄9 weeks TTP had evidence of immunologic activity (three with increased NKC activity). CONCLUSIONS. The median of four previous chemotherapy regimens, with elevated levels of interleukin (IL) 6 and tumor necrosis factor-alfa in most patients, suggests these patients were poor candidates for immunotherapy
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