Editing Cancer vaccine (section)

== Types ==
Cancer vaccines can be cell-based, protein- or peptide-based, gene-based (DNA/RNA).<ref name="Prevent">{{cite journal | vauthors = Lollini PL, Cavallo F, Nanni P, Quaglino E | title = The Promise of Preventive Cancer Vaccines | journal = Vaccines | volume = 3 | issue = 2 | pages = 467–489 | date = June 2015 | pmid = 26343198 | pmc = 4494347 | doi = 10.3390/vaccines3020467 | doi-access = free }}</ref> or live attenuated bacterial- or viral organisms.<ref name="greene">{{Cite journal |last1=Denham |first1=James D. |last2=Lee |first2=Dae Hyun |last3=Castro |first3=Manuel |last4=Pandya |first4=Shuchi |last5=Aslam |first5=Sadaf |last6=Nanjappa |first6=Sowmya |last7=Greene |first7=John N. |date=July 2018 |title=Two cases of disseminated infection following live organism anti-cancer vaccine administration in cancer patients |url=https://www.ijidonline.com/article/S1201-9712(18)30087-0/pdf |journal=International Journal of Infectious Diseases |volume=72 |pages=1–2 |doi=10.1016/j.ijid.2018.04.004 |issn=1201-9712|doi-access=free }}</ref> 

[[Cell-based vaccine]]s include tumor cells or tumor cell lysates.  Tumor cells from the patient are predicted to contain the greatest spectrum of relevant antigens, but this approach is expensive and often requires too many tumor cells from the patient to be effective.<ref name="ant">{{cite journal | vauthors = Tagliamonte M, Petrizzo A, Tornesello ML, Buonaguro FM, Buonaguro L | title = Antigen-specific vaccines for cancer treatment | journal = Human Vaccines & Immunotherapeutics | volume = 10 | issue = 11 | pages = 3332–3346 | date = 2014-10-31 | pmid = 25483639 | pmc = 4514024 | doi = 10.4161/21645515.2014.973317 }}</ref> Using a combination of established cancer cell lines that resemble the patient's tumor can overcome these barriers, but this approach has yet to be effective. Canvaxin, which incorporates three melanoma cell lines, failed phase III clinical trials.<ref name="ant" /> Another cell-based vaccine strategy involves autologous [[dendritic cells]] (dendritic cells derived from the patient) to which tumor antigens are added. In this strategy, the antigen-presenting dendritic cells directly stimulate T-cells rather than relying on processing of the antigens by native APCs after the vaccine is delivered. The best known dendritic cell vaccine is [[Sipuleucel-T]] (Provenge), which only improved survival by four months. The efficacy of dendritic cell vaccines may be limited due to difficulty in getting the cells to migrate to [[lymph nodes]] and interact with T-cells.<ref name="Prevent" />

[[Peptide]]-based vaccines usually consist of cancer specific-epitopes and often require an [[adjuvant]] (for example, [[GM-CSF]]) to stimulate the immune system and enhance antigenicity.<ref name="vax" /> Examples of these epitopes include [[Her2]] peptides, such as GP2 and [[NeuVax]]. However, this approach requires MHC profiling of the patient because of [[MHC restriction]].<ref name="trial">{{cite journal | vauthors = Pol J, Bloy N, Buqué A, Eggermont A, Cremer I, Sautès-Fridman C, Galon J, Tartour E, Zitvogel L, Kroemer G, Galluzzi L | display-authors = 6 | title = Trial Watch: Peptide-based anticancer vaccines | journal = Oncoimmunology | volume = 4 | issue = 4 | pages = e974411 | date = April 2015 | pmid = 26137405 | pmc = 4485775 | doi = 10.4161/2162402X.2014.974411 }}</ref> The need for MHC profile selection can be overcome by using longer peptides ("synthetic long peptides") or purified protein, which are then processed into epitopes by APCs.<ref name="trial" />

Gene-based vaccines are composed of the [[nucleic acid]] (DNA/RNA) encoding for the gene. The gene is then expressed in APCs and the resulting protein product is processed into epitopes. Delivery of the gene is particularly challenging for this type of vaccine.<ref name="Prevent" /> At least one drug candidate, [[mRNA-4157/V940]], is investigating newly developed [[mRNA vaccines]] for use in this application.<ref name="natmed1">{{cite journal |last1= |first1= |last2= |first2= |date=16 June 2023|title=Precision medicine meets cancer vaccines|journal=[[Nature Medicine]]|volume= 29|issue= 6|page= 1287|doi= 10.1038/s41591-023-02432-2|pmid= 37328586|s2cid= 259184146|doi-access= free}}</ref><ref>{{cite journal |last1=Bafaloukos|first1=Dimitrios|date= 2023|title=Evolution and Progress of mRNA Vaccines in the Treatment of Melanoma: Future Prospects|journal=[[List of MDPI academic journals#V|Vaccines]]|volume= 11|issue= 3|page=636 |doi=10.3390/vaccines11030636|pmid=36992220 |pmc=10057252 |doi-access=free }}</ref>

Live attenuated, ampicillin-susceptible [[Listeria monocytogenes]] strains are part of CRS-207 vaccine.<ref name="greene" />