Advances in Cancer Vaccine Development: An Overview of the Latest Clinical Trials in Renal Cell Carcinoma

renal cell carcinoma (RCC) is one of the top ۱۰ most common cancers in the world, with approximately ۳۰% of patients experiencing metastasis. Less than ۱۰% of patients with metastatic RCC survive more than ۵ years. Therapeutic cancer vaccines have shown promising results in improving the quality of life and increasing survival rates by stimulating an immune response against kidney tumors. Given the importance of developing these vaccines, this review presents an overview of the development of vaccines for the treatment of kidney cancers. Method: In this study, data were collected from PubMed, Web of Science, and Scopus databases, with the MESH terms including “kidney neoplasm” and “vaccination”, from ۲۰۱۷ up to Sep ۲۰۲۴. After screening ۱۲ papers, ۹ original studies were included based on the PRISMA protocol. Results: All the reviewed clinical trials examined therapeutic vaccines for renal cell carcinoma (RCC), but mostly on metastatic RCCs. The investigated vaccines varied across studies but were generally classified into four main categories: peptide-based Vaccines, multi-peptide-based Vaccines, Dendritic Cell Vaccines, and tumor cell-based vaccines. These vaccines were administered subcutaneously, intradermally, or by direct injection into the tumor. Across three phase I studies the safety and tolerability of the vaccines were assessed. Two phase II studies evaluated both safety and initial efficacy in larger patient groups, and five phase I/II trials assessed safety and dosage before entering into efficacy analysis. Several clinical trials combined cancer vaccines with other therapeutic modalities, such as standard tyrosine kinase inhibitors (TKI), molecular targeted therapy, conventional chemotherapy, and subcutaneous injection of Class-B CpG oligodeoxynucleotide (CpG-B) and IFN-α. However, it’s important to note that participants in two of the studies were unable to receive standard therapy due to therapeutic intolerance or resistance. The reviewed studies used various endpoints to evaluate both the safety and effectiveness of cancer vaccinations, focusing on key patient outcomes such as survival rates, immunological responses, and adverse events. The primary outcomes included progression-free survival (PFS) and overall survival (OS), which assessed the vaccines' long-term efficacy in managing metastatic renal cell carcinoma. Secondary outcomes encompassed immune response indicators, such as T-cell activation, cytokine production, and antibody titers, which measured the vaccines' ability to induce an antitumor immune response. Overall, these trials demonstrated promising initial efficacy, with none reporting severe or high-grade adverse events; however, some participants experienced mild to moderate reactions, such as injection site reactions and fatigue. Conclusion: In summary, the included trials demonstrate the promising initial safety and efficacy of cancer vaccines in the treatment of metastatic RCC. However, challenges such as patient variability in immune response and the small sample size indicated the need for further investigation. Future research should focus on improving vaccine formulations and exploring optimal combination therapies to improve patient outcomes.

کلیدواژه ها:

Renal cell carcinoma (RCC) ، Cancer vaccines ، Immunotherapy ، Clinical trials