Targeting p53 for immunotherapy of solid tumors

The most common somatic mutations in solid tumors affect the TP53 gene, leading to the formation of the tumor-specific p53 antigen through overexpression of the wild-type antigen (WT-p53) or the generation of mutant-specific neoepitopes (MUT-p53). Thus, the p53 protein is a promising target for immunotherapy. This article summarizes clinical and immunological data on p53-targeting vaccine strategies. Vaccination against WT-p53 is shown to reproducibly induce p53-specific T-cell responses and has a favorable safety profile; however, its clinical efficacy as a monotherapy is limited. Key challenges include central immune tolerance to WT-p53 epitopes, low density of p53 peptide-HLA complexes on the tumor cell surface, an immunosuppressive tumor microenvironment, and HLA (HLA – human leukocyte antigens) heterogeneity. For mutant p53, specific immunogenic epitopes have been validated, yet phase II clinical trials of vaccines targeting frequent p53 mutations are still lacking. Future prospects for enhancing the efficacy of p53-targeted vaccines lie in combination strategies (e.g., with immune checkpoint inhibitors, adjuvants), precise patient stratification, and for mutant p53, the application of TCR-based (TCR – T-cell receptor) technologies and the development of personalized neoantigen selection platforms.