Defining Effective Clinical Responses

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The development and use of cancer vaccines has a long history in experimental medicine. However, to gauge the effectiveness of a cancer vaccine, standard ways to evaluate the immune response must be formulated. Chapter 17, from Dr. Kaufman's laboratory, introduces the various immune assays that are currently being used to monitor responses in clinical cancer vaccine trials. In Chapter 18, the final contribution in this volume, Dr. Whiteside discusses in detail the laboratory services necessary to support a cancer vaccine trial, the assays and limitations of immune monitoring for the detection of tumor-specific T cells after cancer vaccine administration, and the advantages of having a central laboratory operated as a good laboratory practice (GLP) facility to produce the vaccine and perform the immune monitoring assays.

In this volume we have attempted to present some of the best current research on cancer vaccines. We did not include sections devoted to adoptive immunotherapy or dendritic cell strategies for vaccination, as these could serve as volumes in their own right. We also did not concentrate on the identification and testing of new cancer antigens, as this field is also vast and exploding with new targets, due in part to the revolution in gene expression profiling and completion of the human genome project. Our aim was to present examples of how, once identified, antigens can be translated into effective loci of immune stimulation. Cancer vaccine development is still evolving as it changes from a small-scale academic enterprise into an applied science requiring a large clinical infrastructure. Our hope is that we have stimulated further interest in all of these fields, and that the mechanisms for cancer vaccine development presented in this volume will continue to develop. We could think of no better goal than to offer patients a whole new palette of therapeutic options on the basis of our ability to induce tumor immunity.

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