Surgical Research Reviews| Volume 129, ISSUE 3, P248-254, March 2001

Direct detection of cellular immune responses to cancer vaccines

      The sub-optimal anti-tumor efficacy of surgery, chemotherapy, and radiotherapy has prompted the search for additional adjunctive therapies, such as immunotherapy. A variety of immunologic strategies for eradicating tumor cells have shown promise in experimental animal models and are being investigated in preclinical studies and clinical trials. A significant challenge is how to establish most reliably and efficiently which of these approaches are clinically effective. Pivotal trials require considerable resources and time—a randomized trial that demonstrated a significant improvement in disease-free survival for patients with colon cancer receiving an autologous vaccine required about 10 years to complete.
      • Vermorken JB
      • Claessen AM
      • van Tinteren H
      • Gall HE
      • Ezinga R
      • Meijer S
      • et al.
      Active specific immunotherapy for stage II and stage III human colon cancer: a randomised trial.
      Thus, it is important that intermediate markers of efficacy are explored to help select which of many agents to test for clinical benefit. The traditional developmental strategy for a cytotoxic anti-tumor agent relies on tumor regression as an index of efficacy before initiation of phase III trials, which typically monitor survival as an endpoint. However, the induction of specific immune responses may be the most reliable intermediate marker for immunotherapies, especially in trials conducted in patients with minimal tumor burden.
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