Abstract
After twenty years of use in humans, customized idiotypic vaccination yet remains a non-approved, experimental therapeutic option for patients with lymphoma and myeloma. Potentially applicable to all B-cell malignancies whose cells express a clonal immunoglobulin or its epitopes on their surface, this treatment is designed to prevent disease recurrence or progression. Mostly used in follicular lymphoma patients so far, idiotype vaccines have clearly shown biological efficacy, clinical efficacy and clinical benefit in this setting, although no study aiming at regulatory approval of the procedure has been able to meet its main clinical endpoints. In mantle cell lymphoma, only biological efficacy has been proven for idiotypic vaccination, while in multiple myeloma a limited number of studies support the notion of biological and perhaps even clinical efficacy, although no credible evidence of clinical benefit has still emerged. Idiotype vaccines have been produced and administered in a number of substantially different manners. Therefore, the results of most clinical trials cannot be easily compared, and even less pooled together in meaningful meta-analyses. A more creative and yet scientifically sound way to design clinical trials of customized active immunotherapies will be key to the future development of idiotype vaccines, particularly considering that we currently lack any clinical or biological indicator to possibly predict which patients are more likely to respond to idiotypic vaccination from an immunologic point of view. This review aims at summarizing the multifaceted success achieved by idiotype vaccines, as well as at outlining the challenges awaiting them in the near future: how to improve feasibility, immunogenicity and efficacy, as well as how to confirm benefit and gain regulatory approval.
Keywords: Idiotype, vaccine, lymphoma, myeloma, clinical efficacy, clinical benefit, clinical trials
Current Pharmaceutical Design
Title: Idiotype Vaccines for Human B-Cell Malignancies
Volume: 16 Issue: 3
Author(s): S. Inoges, A. Lopez-Diaz de Cerio, E. Soria, H. Villanueva, F. Pastor and M. Bendandi
Affiliation:
Keywords: Idiotype, vaccine, lymphoma, myeloma, clinical efficacy, clinical benefit, clinical trials
Abstract: After twenty years of use in humans, customized idiotypic vaccination yet remains a non-approved, experimental therapeutic option for patients with lymphoma and myeloma. Potentially applicable to all B-cell malignancies whose cells express a clonal immunoglobulin or its epitopes on their surface, this treatment is designed to prevent disease recurrence or progression. Mostly used in follicular lymphoma patients so far, idiotype vaccines have clearly shown biological efficacy, clinical efficacy and clinical benefit in this setting, although no study aiming at regulatory approval of the procedure has been able to meet its main clinical endpoints. In mantle cell lymphoma, only biological efficacy has been proven for idiotypic vaccination, while in multiple myeloma a limited number of studies support the notion of biological and perhaps even clinical efficacy, although no credible evidence of clinical benefit has still emerged. Idiotype vaccines have been produced and administered in a number of substantially different manners. Therefore, the results of most clinical trials cannot be easily compared, and even less pooled together in meaningful meta-analyses. A more creative and yet scientifically sound way to design clinical trials of customized active immunotherapies will be key to the future development of idiotype vaccines, particularly considering that we currently lack any clinical or biological indicator to possibly predict which patients are more likely to respond to idiotypic vaccination from an immunologic point of view. This review aims at summarizing the multifaceted success achieved by idiotype vaccines, as well as at outlining the challenges awaiting them in the near future: how to improve feasibility, immunogenicity and efficacy, as well as how to confirm benefit and gain regulatory approval.
Export Options
About this article
Cite this article as:
Inoges S., de Cerio Lopez-Diaz A., Soria E., Villanueva H., Pastor F. and Bendandi M., Idiotype Vaccines for Human B-Cell Malignancies, Current Pharmaceutical Design 2010; 16 (3) . https://dx.doi.org/10.2174/138161210790170111
DOI https://dx.doi.org/10.2174/138161210790170111 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Role of Neuronal Insulin/Insulin-Like Growth Factor-1 Signaling for the Pathogenesis of Alzheimer’s Disease: Possible Therapeutic Implications
CNS & Neurological Disorders - Drug Targets Targeting Human Telomerase by Antisense Oligonucleotides and Ribozymes: An Update
Medicinal Chemistry Reviews - Online (Discontinued) CXCR3 Axis: Role in Inflammatory Bowel Disease and its Therapeutic Implication
Endocrine, Metabolic & Immune Disorders - Drug Targets Clinical Update: Treatment of Glioblastoma Multiforme with Radiolabeled Antibodies that Target Tumor Necrosis
Current Cancer Therapy Reviews Genetic Polymorphisms of Drug Metabolising Enzymes and Drug Transporters in Relation to Cancer Risk
Current Cancer Therapy Reviews Rituximab The First Monoclonal Antibody Approved for the Treatment of Lymphoma
Current Pharmaceutical Biotechnology T Cell Polarization and the Formation of Immunological Synapses: From Antigen Recognition to Virus Spread
Current Immunology Reviews (Discontinued) Outcome Measures Following Sonodynamic Photodynamic Therapy – A Case Series
Current Drug Therapy Epigenome-Wide Association Studies (EWAS) in Cancer
Current Genomics Water and Ion Channels: Crucial in the Initiation and Progression of Apoptosis in Central Nervous System?
Current Neuropharmacology Current Status of Clinical Trials for Glioblastoma
Reviews on Recent Clinical Trials MALT Lymphoma, Stress Ulcer and Cholinergic Nerves from the Viewpoint of Bilateral and Unilateral Truncal Vagotomy and Substance P
Current Pharmaceutical Design The Development of Future Research Strategies from Reviewing Antiemetic Trials for Chemotherapy Induced Emesis
Reviews on Recent Clinical Trials Targeting the Ataxia Telangiectasia Mutated Protein in Cancer Therapy
Current Drug Targets Exploiting Innate γδ T Lymphocytes for Tumor Immunotherapy
Recent Patents on Biomarkers Methotrexate: Should We Start Using it in Clinical Practice?
Current Drug Targets MicroRNAs in Chronic Lymphocytic Leukemia: An Old Disease with New Genetic Insights
MicroRNA Role of Secondary Alcohol Metabolites in Anthracycline Cardiotoxicity: from Hypotheses to New Drugs
Drug Design Reviews - Online (Discontinued) Signal Transduction by IL-2 and its Receptors as Target in Treatment of Rheumatoid Arthritis
Current Drug Targets - Immune, Endocrine & Metabolic Disorders Drugs for AIDS
Mini-Reviews in Medicinal Chemistry