Title : Vaccine for AML: 2023 and beyond
Abstract:
The idea of using the immune system to fight cancer is over 100 years old. (Paul Ehrlich’s “Magic Bullet”). New cellular and molecular approaches over the last 2 decades or so, led to a better understanding of the immune system. Our focus became the T cell, its development and efficacy to combat cancer. Understanding of immune checkpoint regulation, antagonistic and agonistic in nature (over 20 are now described), development of CAR-T cells, as well as regulation of dendritic cells, B-cells and macrophages, has led to rational clinical development of novel mall molecules, biologics, and other modalities. Immune checkpoint inhibitors (ICI) are currently approved for successful use in many malignant diseases.
Unfortunately, AML is not part of the success; several reasons are a possible explanation:
a. AML lacks a universal specific surface antigen that could be easily targeted. b. AML is highly heterogeneous, so one would need to develop individual targets. 3. the complexity of bone marrow microenvironment. 4. AML often is a fast-progressing disease so reaction of the immune system combined with immune dysfunction makes immunotherapy challenging.
We shall discuss vaccination strategies using individual patients' samples, a variety of antigen models, administration intratumorally, adding adjuvants, and potential combinations with other IO therapies.