|Year : 2016 | Volume
| Issue : 2 | Page : 104-106
J Saraswathy1, J Sunitha1, Nadeem Jeddy2, T Radhika1, R Ananthalakshmi1
1 Department of Oral Pathology, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
2 Department of Microbiology, Thai Moogambigai Dental College, Chennai, Tamil Nadu, India
|Date of Web Publication||6-Jan-2017|
Department of Oral Pathology, Thai Moogambigai Dental College, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Cancer is a disease which has been causing tremendous morbidity and mortality in the current era. It still poses a big question for scientific community as no existing treatment has been able to solve the problem related to this disease. Research has progressed to a considerable extent but has failed to give a complete cure. The development in science and technology has made scientists to seek newer methods of treatment. One such milestone treatment for cancer is cancer vaccine. The aim of cancer vaccine is to stimulate the immune system to prevent the development of cancer cells.
Keywords: Adjuvant; cancer; cancer remedy; malignancy treatment; vaccination
|How to cite this article:|
Saraswathy J, Sunitha J, Jeddy N, Radhika T, Ananthalakshmi R. Cancer vaccine. Indian J Multidiscip Dent 2016;6:104-6
| Introduction|| |
Cancer or malignancy involves uncoordinated abnormal cell growth with the ability to spread or invade different parts of the body. Fifteen million people are affected by cancer per year according to World health Organization (2000), 60% of cancer cases are found in people who are older than 65 years of age. More than 100 different forms of cancer is found. Cancer may arise both from genetic or environmental factors that lead to aberrant growth regulation of a stem cell population or by the differentiation of more mature cell types. Normally, cells proliferate only to replace cells that have undergone apoptotic cell death. A majority of cancers are caused by changes in the cells DNA due to environmental and genetic damage. These mutations in DNA appear to disrupt this orderly process of cell death. The environmental factors that cause initial mutation are called carcinogens, for example, ultraviolet rays and industrial pollutants. 
Vaccines are medicines are used to that boost the immune system's natural ability to protect the body against "foreign invaders." Cancer vaccine belongs to a class of substance known as biological response modifiers. They work by inducing the immune system's ability to fight against infections and disease. The aim of cancer vaccine is to stimulate the immune system to recognize abnormal cancer cell and destroy them. The term cancer vaccine refers to a vaccine which prevents the virus causing cancer such as human papillomavirus, herpes simplex virus, Epstein-Barr virus, hepatitis C virus, hepatitis B virus, human immunodeficiency virus or it should prevent the development of cancer in high risk in an individual. 
Preventive vaccine or prophylactic: Preventive vaccine which are intended to prevent cancer from developing in healthy individual. 
Therapeutic vaccine: Vaccine which is intended to attack existing cancer by strengthening the body s natural defense against cancer. 
Specific cancer vaccine: As the name indicates, they treat specific type of cancer. Different vaccines need to treat different types of cancer.
Universal cancer vaccine: They fight cancer cells regardless of cancer types.
The following list includes cancer vaccine being developed, antigen vaccines, viral-vector based vaccines, anti-idiotype antibody-based vaccines, dendritic cell vaccines, tumors cell vaccines and DNA vaccines. ,
Cancer vaccines are made from the person's own cancer cell or cells grown in laboratory. Cancer cells are heat treated so that they lose their ability to multiply and grow, ensuring thereby that they do not cause any harm to the individual being treated. Certain protein may also be isolated from these cancer cells, to make cancer vaccine. These includes proteins like antigens, present on the cell surface that can stimulate an immune response. 
Cancer vaccines are designed for tumor-specific immune responses, specifically to cytotoxic CD8 positive T-cells that are seen in tumor antigens. The older vaccines, which were developed in the last decade shared tumor nonmutated associated antigens that have been shown to be immunogenic. Recently, technological developments have enabled the investigation of vaccines that target mutated antigens that are patient specific. Cancer vaccines use polypeptides, amino acids, antigen presenting cells, neoplastic cells, and viral vectors to develop a vaccine. Standard treatments, such as surgery, ablation, chemotherapy and radiotherapy can also results in antitumor immunity and can have enhanced the effects on cancer vaccine. Currently, combination therapies are being applied in clinical trials and are likely to be the better approach in improving patient outcomes. 
| Antigen Vaccine|| |
Antigen vaccines are tumor specific antigens which stimulate the immune system. These antigens are made up of protein or peptides. By injecting these antigens into the cancer patient the immune system is stimulated produce an increased amount of antibodies or killer T-cell. Antigen vaccine boost the immune system using only one key. 
| Whole Tumor Cell Vaccine|| |
Whole cell vaccines or polyepitope vaccines are prepared using the entire cells or ex vivo viruses. The clear advantage of whole tumor cell vaccines is that it is effective against a number of antigen and can also be customized for each individual.
Multiple antigen or unknown antigens may target both innate and adaptive immune system. Genetic modification of cell to provide cytokines and co-stimulation may further augment the action. The main disadvantages of whole-cell tumor vaccine are that the tumor cells are generally not immunogenic. To improve the immune response, an ingredient called adjuvant is added to vaccine. The adjuvant licensed for human use in the United States is an alum adjuvant and monophosphoryl lipid (MF59) + alum, known as AS04. 
There are two types of tumor cell vaccine based on the cell of origin of the vaccine. Allogenic and autologous.
- Allogenic: Vaccine made from tumor cell taken from individual other than patient 
- Autologous: Vaccine made from antigen taken from a patient's own cancer cell or in this vaccine, antigens are derived from patient itself and induce regression of synergic tumors. 
A variety of cancer cell is used in tumor cell vaccine.
- Tumor lysate: Tumor lysate is made from destroyed tumor cell
- Tumor oncolysate: An extract made from infected cancer cell with a strain of virus destructive to the cancer cells
- Transduced tumor cell: Cancer cell that has been altered through genetic engineering to include genetic material from cytokines
- Whole tumor cell
- Apoptotic bodies: Fragment of cell that has died naturally 
- Multiple antigen can be used in this kind of vaccine to alter the response of the immune system.
| Anti-idiotype Antibody-Based Vaccine|| |
Each B-lymphocyte generates only single kind of antibody with the significant part of each type of antibody is called an idiotype as well as a the variable region. The immune system will produce anti-idiotype antibodies to attack the idiotype antibodies produced to keep a control of the immune antibodies. This principle is employed for vaccine development and lymphomas are showing promising results for anti-idiotype vaccines in clinical trials. 
| Dendritic Cell Vaccine|| |
Dendritic cells (DCs) are specialized antigen presenting cells. Such cells help the immune system to recognize cancer cells and present the cancer cells to T-lymphocytes. These cells can break down cancer cells into small pieces which can induce antigen. Tumor antigen are used alone or combined with DC in various form to produce vaccine. Osada et al. have been able to differentiate DC which involves a complex and expensive process. Cells that differentiate into DCs are isolated from the patient blood. This process allows getting more autologous DCs. Then these cells are either exposed to cancer cells or cancer antigen or engineered to express the cancer cell antigen or fuse with tumor cells. Before injection into a patient, the complex of DC-antigen or DC-tumor must undergo a maturation process. This process is required for improving the ability to activate T-cells.  DC vaccine/tumor fusion vaccine have demonstrated in many animal studies, that it provided not only protection against challenge with tumor cell but also caused regression. 
| DNA Vaccine|| |
DNA vaccine has been developed with the purpose to provide a way to supply a steady antigen and keep the immune response going. The problem with the previous vaccines discussed are that once they are injected into the body as a vaccine; they usually cause the desired immune response at first. However, over time they may become less effective. The principal reason is that the immune systems recognizes them, antigen or cell, as foreign molecules and quickly destroys them. Without any other stimulation, the immune system will return to its normal state of activity.
DNA vaccines are based on bacterial plasmid that has been engineered to express the desired gene under a eukaryotic promoter element that is active in mammalian cells. Two types of vectors employed prokaryotic and eukaryotic. Prokaryotic vectors used, have a homologous sequence with the mammalian genome allowing them to be incorporated in the target sequence in the mammalian genome. The last vector does not have a eukaryotic origin of replication and is considered less hazardous. The idea behind both vectors is the same. First, the antigen encoded is produced in the mammalian cell. Once the antigen is properly transcribed and folded it is recognized by either the humoral immune system or the innate immune system, creating a network response against cells presenting the encode antigen. 
| Conclusion|| |
Researchers must carefully evaluate which cancers are most suitable for a therapeutic vaccine approach. In general, cancers that are the best candidates are those whose treatments are associated with high costs and therapies that are less effective, or therapies that involve the risk of serious side effects for the patient.  The vaccine development for cancer is an exemplary approach of researchers to fight the most dreadfull disease around the globe. The various types of cancer vaccines and their clinical trials are most satisfactory and have shown giving hope to the scientific community to concentrate more in this area. Future progress and development in this area will surely provide the human kind with weapons to fight with all kinds of cancer. 
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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