Non-small cell lung cancer (NSCLC) unfortunately carries a very poor prognosis. Patients usually do not become symptomatic, and therefore do not seek treatment, until the
cancer is advanced and it is too late to employ curative treatment options. New therapeutic options are urgently needed for NSCLC, because even current targeted
therapies cure very few patients. Active immunotherapy is an option that is gaining more attention. A delicate and complex interplay exists between the
tumor and the immune system. Solid
tumors utilize a variety of mechanisms to evade immune detection. However, if the immune system can be stimulated to recognize the
tumor as foreign,
tumor cells can be specifically eliminated with little systemic toxicity. A number of
vaccines designed to boost immunity against NSCLC are currently undergoing investigation in phase III clinical trials.
Belagenpumatucel-L, an allogeneic cell
vaccine that decreases
transforming growth factor (TGF-β) in the tumor microenvironment, releases the immune suppression caused by the
tumor and it has shown efficacy in a wide array of patients with advanced NSCLC.
Melanoma-associated
antigen A3 (MAGE-A3), an
antigen-based
vaccine, has shown promising results in MAGE-A3(+) NSCLC patients who have undergone complete surgical resection.
L-BLP25 and
TG4010 are both antigenic
vaccines that target the
Mucin-1 protein (MUC-1), a proto-oncogene that is commonly mutated in solid
tumors. CIMAVax is a recombinant human
epidermal growth factor (
EGF)
vaccine that induces anti-
EGF antibody production and prevents
EGF from binding to its receptor. These
vaccines may significantly improve survival and quality of life for patients with an otherwise dismal NSCLC prognosis. This review is intended to give an overview of the current data and the most promising studies of active immunotherapy for NSCLC.