Five unanswered questions regarding personalized neoantigen cancer vaccines
From data presented at both AACR and ASCO in the past months, amazing progress continues to be made in the development of neoantigen vaccines. As we marvel at the growth and big steps forward, let’s assess what still remains unclear or represents a significant challenge for cancer investigators working on these transformational therapies.
1. In what cancer types will these vaccines prove to be the most effective?
Understanding which cancer types, and subtypes, will derive benefit from a neoantigen vaccine approach has not yet been established. The first-in-human clinical trials have focused on choices such as melanoma that have a high mutation rate (Ott et al. 2017, Sahin et al. 2017). However, as Catherine Wu from Dana-Farber Cancer Institute put forth in her 2018 AACR platform, “Can a vaccination approach be tested in lower mutation rate tumors?” Her group is actively trying to address this question using a more challenging cohort of glioblastoma multiforme (GBM) patients. With fewer neoantigen targets, can an effective immune response be generated with a vaccine? Along with selecting the appropriate cancer type, the proper schedule, dosing, delivery mechanisms and adjuvants are also further considerations (Ott et al 2018).
Along with cancer type, what formulations, adjuvants, and delivery vehicles will make for an effective neoantigen vaccine?
Mechanisms and components of an effective cancer vaccine, from Ott et al. 2018