![]() This leads to an ever-increasing number of potential vaccine targets as well as validation of those targets through preclinical and early clinical cancer vaccine development. At present, investigator-initiated funding of science dictates innovation (i.e., that each investigator discovers and develops his/her own antigens). The task of ranking cancer antigens is immense, and the number of potential cancer antigens is almost limitless. Our current effort to prioritize cancer antigens represents the logical next step in attempting to focus translational efforts on cancer vaccine regimens with the highest potential for success. Many of the ranked immunotherapeutic agents are effective as components of cancer vaccine regimens in preclinical models, but this abundance of promising opportunities raises immediate questions as to which antigen or sets of antigens are most appropriate for codevelopment. 9 The ranking was based on the likelihood for efficacy in cancer therapy and was exceedingly well vetted, with broad and substantial input from academia, industry, and the government. A National Cancer Institute (NCI) immunotherapy agent workshop was held in July 2007 to rank agents with high potential to serve as immunotherapeutic drugs. Limited resources mandate transparent methods to prioritize developmental opportunities with the least possible bias. Nevertheless, there is consensus that optimally designed cancer vaccine trials combining the best antigens with the most effective immunotherapy agents might yield positive clinical results.Ĭancer vaccine development is limited by several factors, including funding constraints. No cancer vaccine has yet been approved by the Food and Drug Administration despite extensive developmental efforts by academia and industry. Scores of cancer vaccines are immunogenic in clinical trials, and many of them have shown efficacy in at least small numbers of patients. ![]() Virtually any mutant, overexpressed or abnormally expressed protein in cancer cells, can serve as a target for cancer vaccines and/or T-cell therapy ( 1 – 75 ). These findings reflect the current status of the cancer vaccine field, highlight the possibility that additional organized efforts and funding would accelerate the development of therapeutically effective cancer vaccines, and accentuate the need for prioritization. ![]() However, 46 were immunogenic in clinical trials and 20 of them had suggestive clinical efficacy in the “therapeutic function” category. None of the 75 antigens had all of the characteristics of the ideal cancer antigen. Using the pairwise approach, the result of criteria weighting, in descending order, was as follows: (a) therapeutic function, (b) immunogenicity, (c) role of the antigen in oncogenicity, (d) specificity, (e) expression level and percent of antigen-positive cells, (f) stem cell expression, (g) number of patients with antigen-positive cancers, (h) number of antigenic epitopes, and (i) cellular location of antigen expression. Antigen prioritization involved developing a list of “ideal” cancer antigen criteria/ characteristics, assigning relative weights to those criteria using pairwise comparisons, selecting 75 representative antigens for comparison and ranking, assembling information on the predefined criteria for the selected antigens, and ranking the antigens based on the predefined, preweighted criteria. An additional aim was for the National Cancer Institute to test a new approach for prioritizing translational research opportunities based on an analytic hierarchy process for dealing with complex decisions. The purpose of the National Cancer Institute pilot project to prioritize cancer antigens was to develop a well-vetted, priority-ranked list of cancer vaccine target antigens based on predefined and preweighted objective criteria. The Prioritization of Cancer Antigens: A National Cancer Institute Pilot Project for the Acceleration of Translational Research
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