The clinical landscape of therapeutic cancer vaccines: the next breakthrough in cancer immunotherapy?

Over the past century, therapeutic cancer vaccines (TCVs) have been widely investigated in meaningful preclinical studies and clinical trials that aim to enhance the patient's adaptive immune system against cancers (Fig. S1A) [ [1] Saxena M. van der Burg S.H. Melief C.J.M. Bhardwaj N. Therapeutic cancer vaccines. Nat Rev Cancer. 2021; 21: 360-378 Crossref PubMed Scopus (314) Google Scholar ]. The basic functional principles of TCVs include delivering a large number of tumour-specific antigens (TSAs) or tumour-associated antigens (TAAs) to dendritic cells (DCs), enhancing DC activation, inducting robust cytotoxic T lymphocyte (CTL) responses, and sustained immune infiltration of the tumour microenvironment (TME) [ [2] Lin M.J. Svensson-Arvelund J. Lubitz G.S. Marabelle A. Melero I. Brown B.D. et al. Cancer vaccines: the next immunotherapy frontier. Nat Can (Que). 2022; 3: 911-926 Crossref PubMed Scopus (33) Google Scholar ]. Unlike targeted tumour therapy, TCVs may be safer by avoiding off-target effects. Compared with other immunotherapies, TCVs can induce more sustained and stronger T cell activity in tumour tissues. Due to the clear theoretical rationale and encouraging preclinical data, TCVs capture immense attention from researchers and the pharmaceutical industries [ [3] Corti C. Giachetti P. Eggermont A.M.M. Delaloge S. Curigliano G. Therapeutic vaccines for breast cancer: has the time finally come?. Eur J Cancer. 2022; 160: 150-174 Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar ]. It is expected that clinical trials involving TCVs will soon facilitate the translation of findings from basic studies to clinical practice. Therefore, numerous clinical trials of TCVs have been completed or are underway, worldwide, to continue to explore the clinical value of this cancer therapeutic approach [ [4] Melero I. Gaudernack G. Gerritsen W. Huber C. Parmiani G. Scholl S. et al. Therapeutic vaccines for cancer: an overview of clinical trials. Nat Rev Clin Oncol. 2014; 11: 509-524 Crossref PubMed Scopus (563) Google Scholar ]. In this work, we analyse and summarise the current state of TCV clinical trials, based on the public clinical trial database, to present latest advancements in clinical progress in this field. In addition, we discuss the difference in clinical trial parameters between China and the rest of the world.