Advancements and Challenges in Peptide-Based Cancer Vaccination: A Multidisciplinary Perspective
Abstract
:1. Introduction
2. The Current Status of Peptide Vaccine Development: Promising Potential Amidst Challenges
3. Mechanism of Action of Peptide Cancer Vaccines
3.1. Selection of Target Antigens
3.2. Vaccine Formulation
3.3. Presentation and T-Cell Activation in Peptide-Based Cancer Vaccines
3.4. Enhancing CTL Response Induction
3.5. Cold Chain Transport
4. Current Peptide-Based Cancer Vaccines
5. Peptide-Based Cancer Vaccines Combination Therapy: A Promising Approach
5.1. Combination Therapy with Targeted Therapy and Immunotherapy
5.2. Combination Therapy with Chemotherapy
5.3. Combination Therapy with Radiotherapy
6. Administration and Monitoring Protocols
7. Adverse Events: Present but Manageable
8. Adjuvants
8.1. GM-CSF
8.2. TLR Agonists
9. Targeted Delivery Systems
9.1. Utilizing Ligands for Enhanced Therapeutic Efficacy
9.2. Liposomes
9.3. Polymeric Micelle
9.4. AuNP
10. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Glossary
AFP | Alpha-fetoprotein |
AML | Acute myeloid leukemia |
APCs | Antigen-presenting cells |
AuNP | Gold nanoparticle |
CEA | Carcinoembryonic antigen |
CPA | Cyclophosphamide |
CRT | Chemoradiation therapy |
CRS | Cytokine release syndrome |
CTLA-4 | Cytotoxic T-lymphocyte-associated protein 4 |
CTLs | Cytotoxic T lymphocytes |
DCs | Dendritic cells |
EGFRvIII | Epidermal growth factor receptor variant III |
ESCC | Esophageal squamous cell carcinoma |
FDA | Food and Drug Administration |
GM-CSF | Granulocyte-macrophage colony-stimulating factor |
HER2 | Human epidermal growth factor receptor 2 |
HCC | Hepatocellular carcinoma |
HLA | Human leukocyte antigen |
HPV | Human papillomavirus |
IFA | Incomplete Freund’s adjuvant |
IFN | Interferon |
IL | Interleukin |
IDH1 | Isocitrate dehydrogenase 1 |
KRAS | Kirsten rat sarcoma viral oncogene homolog |
LNPs | Lipid nanoparticles |
LPS | Lipopolysaccharide |
MAGE | Melanoma antigen gene |
MDSCs | Myeloid-derived suppressor cells |
MHC | Major histocompatibility complex |
MPLA | Monophosphoryl lipid A |
NSCLC | Non-small-cell lung cancer |
NY-ESO-1 | New York esophageal squamous cell carcinoma 1 |
ODNs | Oligodeoxynucleotides |
OS | Overall survival |
OVA | Ovalbumin |
PFS | Progression-free survival |
PD-1 | Programmed cell death protein 1 |
PD-L1 | Programmed death-ligand 1 |
PPV | Personalized peptide vaccination |
PSA | Prostate-specific antigen |
TAAs | Tumor-associated antigens |
TCR | T-cell receptors |
TLR | Toll-like receptor |
Tregs | Regulatory T cells |
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Target Antigens | Class of Tumor Antigen | Description | Tumor Specificity | Example of Tumor Antigen | Immunogenicity | Immunotherapy Strategy | References |
---|---|---|---|---|---|---|---|
TAAs | Overexpressed antigens | Normal proteins overexpressed in tumor cells. | Low | HER2 in breast cancer | Moderate | Targeted antibody therapies | [70,71] |
Differentiation antigens | Proteins associated with the differentiated state, present in both tumor and tissue of origin. | Low | MART-1 in melanoma | High | Peptide vaccines, T-cell therapies | [72,73] | |
Cancer-testis antigens | Normally expressed only in the testis but found in various tumors. | Moderate | NY-ESO-1 in melanoma | High | Cancer vaccines, adoptive T-cell transfer | [74,75,76] | |
Oncofetal antigens | Expressed during fetal development and re-expressed in tumors. | Low | CEA in colorectal cancer | Moderate | Antibody–drug conjugates, vaccines | [77,78] | |
TSAs | Viral antigens | From oncogenic viruses, absent in normal cells. | High | HPV E6 and E7 in cervical cancer | High | Preventive vaccines, therapeutic vaccines | [79,80,81] |
Neoantigens | Unique antigens from tumor-specific alterations. | High | KRAS G12D in various cancers | Very High | Personalized neoantigen vaccines, TCR-engineered T cells | [82,83,84] | |
Mutated antigens | Arise from mutations, creating novel peptides absent in normal cells. | High | IDH1 R132H in glioma | High | Neoantigen vaccines, TCR-engineered T cells | [82,83,85,86] |
Vaccine | Mechanism | Applications | Advantages | Disadvantages | Development Time | References |
---|---|---|---|---|---|---|
NY-ESO-1 Peptide Vaccine | Targets cancer-testis antigen NY-ESO-1. | Melanoma, ovarian cancer, sarcoma | Targets a tumor-specific antigen, potential for broad application, immunogenic | Limited to NY-ESO-1-positive tumors, limited clinical data, ongoing clinical trials | Late 1990s | [120,121,127,128] |
MUC1 Peptide Vaccine | Targets MUC1 protein, which is overexpressed in adenocarcinomas. | Breast cancer, pancreatic cancer | Targets a common cancer antigen, potential for broad application, immunogenic | Limited efficacy as monotherapy, high cost, ongoing clinical trials | Early 2000s | [129,130,131] |
WT1 Peptide Vaccine | Targets WT1 protein to stimulate immune response. | AML, mesothelioma | Targets a universal cancer marker, potential broad application, immunogenic | Limited clinical data, ongoing clinical trials, variability in patient response | Early 2000s | [123,132,133] |
NeuVax (E75) | Targets HER2/neu-derived peptides to prevent recurrence. | Breast cancer | Potential to prevent recurrence, targets specific antigen, combinable with other therapies | Limited to HER2-positive cancers, variability in patient response, ongoing clinical trials | Early 2000s | [118,134] |
HER-2/neu Peptide Vaccine (GP2) | Targets HER2/neu protein, common in various cancers. | Breast cancer | Targets specific cancer marker, potential to prevent recurrence, combinable with other therapies | Limited to HER2-positive cancers, variability in patient response, ongoing clinical trials | Early 2000s | [118,135,136] |
MAGE-A3 Peptide Vaccine | Targets MAGE-A3 antigen. | Melanoma | Targets specific cancer marker, potential for broad application, immunogenic | Limited to MAGE-A3-positive tumors, limited clinical data, ongoing clinical trials | Early 2000s | [122,137,138] |
Rindopepimut (CDX-110) | Targets EGFRvIII mutation. | Glioblastoma | Specific to tumor mutation, potential for personalized treatment, combinable with other therapies | Limited to EGFRvIII-positive tumors, limited clinical data, high cost | Early 2000s | [139,140] |
IMA901 | Multipeptide vaccine targeting multiple tumor-associated antigens. | Renal cell carcinoma | Targets multiple antigens, can be personalized, potential synergy with other therapies | Limited efficacy in monotherapy, not widely available, clinical trials ongoing | Mid 2000s | [116,117] |
GV1001 | Targets telomerase to provoke an immune response. | Pancreatic cancer, NSCLC | Targets a universal cancer marker, potential broad application, immunogenic | Limited efficacy as monotherapy, high cost, side effects | Late 2000s | [115,141] |
IDH1 Peptide Vaccine | Targets mutant IDH1 protein. | Glioma | Specific to tumor mutation, potential for personalized treatment, immunogenic | Limited to IDH1-mutant tumors, limited clinical data, ongoing clinical trials | Late 2000s | [85,142] |
SurVaxM | Targets survivin to inhibit apoptosis and stimulate an immune response. | Glioblastoma | Targets a universal cancer marker, potential broad application, immunogenic | Limited clinical data, ongoing clinical trials, high cost | Early 2010s | [143,144] |
KRAS Peptide Vaccine | Targets mutant KRAS protein. | Colorectal cancer, pancreatic cancer, NSCLC | Specific to tumor mutation, potential for personalized treatment, immunogenic | Limited to KRAS-mutant tumors, limited clinical data, ongoing clinical trials | Late 2010s | [124,145,146,147] |
Types of Combination Therapy | Condition or Disease | Combination Therapy Drugs | Peptide-Based Tumor Vaccines | Phase | Enrollment | Treatment Effect | Monotherapy | Combined Therapy | ClinicalTrials.gov ID | Reference |
---|---|---|---|---|---|---|---|---|---|---|
Peptide-based tumor vaccines and targeted therapy | Advanced or metastatic renal cell carcinoma | Sunitinib | IMA901 | III | 1171 patients | No improvement in OS (p = 0.087) | Sunitinib monotherapy group Median OS (33.67 months) | Sunitinib plus IMA901 group Median OS (33.17 months) | NCT01265901 | [117] |
Peptide-based tumor vaccines and immunotherapy | Metastatic melanoma | Ipilimumab | gp100 | III | 676 patients | Improve OS (p < 0.001) | gp100 monotherapy group Median OS (6.4 months months) | ipilimumab plus gp100 Median OS (10.0 months) | NCT00094653 | [150] |
Human papillomavirus 16-related cancer | Nivolumab | ISA101 | II | 24 patients | Enhanced tumoricidal effects | 33% response rate and 17.5-month median OS versus PD-1 alone | NCT02426892 | [161] | ||
Peptide-based tumor vaccines and chemotherapy | Locally advanced or metastatic pancreatic cancer | Gemcitabine and capecitabine | GV1001 | III | 1062 patients | Do not significantly improve OS | Chemotherapy group (7.9 months); the sequential (6.9 months, HR 1.19); concurrent chemoimmunotherapy groups (8.4 months, HR 1.05) | NCT00425360 | [141] | |
EGFRvIII-expressing glioblastoma | Temozolomide | CDX-110 | III | 745 patients | Do not increase survival (p = 0.93) | temozolomide monotherapy group Median OS (20.0 months) | rindopepimut plus temozolomide Median OS (20.1 months) | NCT01480479 | [140] | |
Advanced solid tumors | Cyclophosphamide | RNF43 | I | 10 patients | Stable disease in six out of ten patients and an increase in tumor-reactive CD8+ T cells | – | – | – | [162] | |
Biliary tract cancer | Cyclophosphamide | Personalized peptide vaccination | II | 49 patients | Significantly improved PFS (p = 0.008) and OS (p = 0.004) | personalized peptide vaccination monotherapy group (PFS median time: 2.9 months; OS median time: 5.9 months) | Low dose cyclophosphamide plus personalized peptide vaccination (PFS median time: 6.1 months; OS median time: 12.1 months) | – | [163] | |
Peptide-based tumor vaccines and radiotherapy | Esophageal cancer | Cisplatin and 5-fluorouracil | TTK, URLC10, KOC1, VEGFR1, and VEGFR2 | I | 11 patients | Well tolerated, induced peptide-specific cytotoxic T-lymphocyte responses in all patients | – | – | NCT00632333 | [156] |
Advanced HCC | – | personalized peptide vaccination | I | 9 patients | Well tolerated, parts of patients’ AFP levels decreased and their conditions stabilized | – | – | – | [164] |
Adjuvant | Description | Mechanism | Applications | References |
---|---|---|---|---|
Alum | One of the oldest and most widely used adjuvants, including aluminum hydroxide and aluminum phosphate. | Forms a depot, enhances APC uptake, induces Th2 response. | Hepatitis A and B, DTP vaccines. | [206] |
MF59 | An oil-in-water emulsion containing squalene. | Enhances APC recruitment and activation, balanced Th1/Th2 response. | Influenza vaccines (e.g., Fluad). | [207] |
AS04 | A combination of aluminum hydroxide and monophosphoryl lipid A. | Stimulates TLR4, activates APCs, strong Th1 response. | HPV vaccine (Cervarix). | [208] |
CpG ODNs | Synthetic oligodeoxynucleotides containing unmethylated CpG motifs that mimic bacterial DNA. | Activates TLR9, cytokine production, strong Th1 response. | Cancer and infectious disease vaccines. | [209] |
MPLA | A detoxified derivative of LPS that retains immunostimulatory properties without toxicity. | Activates TLR4, enhances humoral and cell-mediated immunity. | HPV vaccines (AS04 system). | [193] |
Saponins (e.g., QS-21) | Plant-derived compounds that form complexes with cholesterol to enhance immune responses. | Enhances immune responses, stimulates Th1/Th2. | Shingrix vaccine. | [210] |
Toll-like receptor agonists | Compounds that mimic PAMPs to stimulate TLRs. | Activates TLRs, enhances innate and adaptive responses. | Cancer and infectious disease vaccines. | [211] |
GM-CSF | Granulocyte-macrophage colony-stimulating factor. | Stimulates the production and activation of dendritic cells and macrophages. | Melanoma vaccines, various cancer immunotherapies. | [186] |
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Liu, D.; Liu, L.; Li, X.; Wang, S.; Wu, G.; Che, X. Advancements and Challenges in Peptide-Based Cancer Vaccination: A Multidisciplinary Perspective. Vaccines 2024, 12, 950. https://doi.org/10.3390/vaccines12080950
Liu D, Liu L, Li X, Wang S, Wu G, Che X. Advancements and Challenges in Peptide-Based Cancer Vaccination: A Multidisciplinary Perspective. Vaccines. 2024; 12(8):950. https://doi.org/10.3390/vaccines12080950
Chicago/Turabian StyleLiu, Dequan, Lei Liu, Xinghan Li, Shijin Wang, Guangzhen Wu, and Xiangyu Che. 2024. "Advancements and Challenges in Peptide-Based Cancer Vaccination: A Multidisciplinary Perspective" Vaccines 12, no. 8: 950. https://doi.org/10.3390/vaccines12080950