Cancer treatment reviews
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Cancer treatment reviews · Feb 1999
ReviewGenetically modified tumour vaccines--where we are today.
Tumour vaccines are based on weakly immunogenic specific tumour antigens admixed with adjutants in order to elicit, restore or augment antitumour immune responses against residual or metastatic tumour cells. Cellular cytotoxicity is considered to play a major role in eliminating tumour cells. Activation of cellular toxicity requires at least three synergistic signals: presentation of specific tumour antigen, constimulatory signal (B7 molecules) and propagation signal (cytokines). ⋯ Dendritic cells are modified with genes of specific tumour antigens in order to activate both helper and cytotoxic T-cells. Novel vaccines produce specific immune responses and objective clinical responses with minimal toxicity in phase I/II trials. Advances in gene transfer technology, tumour immunology and better methods of monitoring specific antitumour immune responses allow the hope that tumour vaccines will be introduced into the clinic, at least in some malignancies resistant to systemic therapy so far such as melanoma and renal cell carcinoma.
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Paclitaxel, a novel antitumour agent, is active clinically against advanced ovarian and breast cancer and under investigation for various other cancers. One of the problems associated with the intravenous administration of paclitaxel is its low solubility in water. ⋯ Therefore the development of a safer intravenous formulation devoid of Cremophor EL is an important investigational issue. This review deals with some of the most promising formulation alternatives.