Cellular immunotherapy for cancer: current concepts and clinical perspectives scientific basis and approaches for therapeutic cancer vaccines. Part I.

Tumour immunotherapy is not a new concept. Since the original (and partially successful) attempts at using bacterial products to treat sarcomas by William Coley 100 years ago, the number of immunologically based anticancer therapies has increased almost exponentially. This pathway has not been smooth and uniform, and the most basic concepts continue to be challenged. In particular, the role of the immune system in the development and eradication of malignant disease, the so-called ‘immune surveillance’, remains controversial [1,2]. Nevertheless, the recent resurgence of interest in this field has resulted in a large portfolio of clinical trials, some of which are now at the phase III stage. This remarkable progress has only been made possible by advances in key areas, including the development of monoclonal antibody technology, the identification of tumour-associated antigens (TAA), the insights into the molecular basis of antigen presentation and T-cell activation, the development of gene transfer technology, and the identification, large-scale culture and manipulation of powerful antigen-presenting dendritic cells. In this review, we will discuss the scientific basis for cellular cancer immunotherapy and recent developments in the identification of TAA and their interactions with T cells. The various approaches to cancer immunotherapy will be described, along with the new techniques being used to evaluate the immune response (the so-called ‘immunological readouts’). Finally, we present an overview of important ongoing or completed clinical trials of cellular immunotherapy for cancer.