Vaccine Development to Avoid Breast Cancer: Advancing Cancer Immunotherapy through Vaccine Development

Abstract

Cancer vaccines have been fraught with many failures but have had a few recent successes. In order for this research to remain viable, major progress must be made to improve clinical outcomes in cancer immunotherapy. While there are no clear winners among the various strategies outlined, multiple approaches may be needed to provide a breast cancer vaccine to the majority of women due to differences in immunologic compatibility. The ultimate goal of breast cancer vaccines should be to reduce the risk of recurrence from minimally residual disease in patients with no evidence of disease following or in combination with endocrine therapy, chemotherapy, radiotherapy, and novel immunomodulators. While breast cancer vaccines may provide additional palliative benefits to patients with metastatic disease, this approach will likely need to be combined with chemotherapy and immunomodulators to improve outcomes significantly. Proper clinical trial design geared specifically toward cancer immunotherapy with rigorous immune monitoring methods and appropriate endpoints is essential in developing novel breast cancer vaccines. With intense collaboration, we may someday be able to stimulate the immune system's response to target specific cells as a means to cure breast cancer with improved precision, less toxicity to healthy cells, and minimal side effects. Years of unsuccessful attempts at fighting established tumors with vaccines have taught us all that they are only able to truly impact patient survival when used in a preventive setting, as would normally be the case for traditional vaccines against infectious diseases. A combination of immunopreventive cancer strategies and recently approved checkpoint inhibitors is a further promise of forthcoming successful cancer disease control, but prevention will require a considerable reduction of currently reported toxicities. These considerations summed with the increased understanding of tumor antigens allow space for an optimistic view of the future.