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Cancer stem cell antigen-based vaccines: The preferred strategy for active specific immunotherapy of metastatic melanoma?

机译：基于癌症干细胞抗原的疫苗：转移性黑色素瘤主动特异性免疫治疗的首选策略？

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Introduction: There are now two chemotherapy agents, one tyrosine kinase inhibitor and three immunotherapy products approved for the treatment of metastatic melanoma, but an unmet need persists because these options are toxic and of limited therapeutic benefit. Active specific immunotherapy with therapeutic vaccines could be a useful addition to the therapeutic armamentarium, especially in patients whose tumor burden has been reduced by other treatment modalities. Areas covered: This article reviews various sources of melanoma antigens, such as peptides, gangliosides, autologous tumor and cancer stem cells including allogeneic and autologous cell lines. The advantages and disadvantages of various antigen sources and allogeneic and autologous approaches are discussed with an emphasis on the theoretical benefits of immunizing against cancer stem cells. The results from published randomized trials testing the benefit of various vaccine approaches are summarized, as well as promising results from three Phase II trials (one randomized) of patient-specific stem cell antigen-based products. Expert opinion: Immune responses directed toward the unique neoantigens and stem cell antigens expressed on continuously proliferating, self-renewing, autologous tumor cells could potentially overcome the limitations inherent in these other antigen-based approaches, that to date, have yielded disappointing results in randomized trials.
机译：简介：现在已经批准了两种化学疗法药物，一种酪氨酸激酶抑制剂和三种免疫疗法产品被批准用于治疗转移性黑色素瘤，但是由于这些选择具有毒性且治疗效果有限，因此仍未满足需求。使用治疗性疫苗的主动特异性免疫疗法可能是治疗性武器库的有用补充，尤其是在其肿瘤负荷已通过其他治疗方式减轻的患者中。涵盖领域：本文概述了黑色素瘤抗原的各种来源，例如肽，神经节苷脂，自体肿瘤和癌症干细胞，包括同种异体和自体细胞系。讨论了各种抗原来源以及同种异体和自体方法的优缺点，重点是针对癌症干细胞进行免疫接种的理论益处。总结了已发表的测试各种疫苗方法的益处的随机试验的结果，以及三项针对患者的基于干细胞抗原的产品的II期试验（一项随机试验）的有希望的结果。专家意见：针对独特的新抗原和干细胞抗原的免疫反应在持续增殖，自我更新，自体肿瘤细胞上表达可能会克服这些其他基于抗原的方法固有的局限性，迄今为止，这些方法在随机分组中已产生令人失望的结果审判。

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