The immune system has the capacity to discriminate between self and nonself forms. However, within the tumor microenvironment, there are numerous mechanisms of immunosuppression that contrast this process in vivo. An antitumor vaccine is a therapeutic strategy that promotes a strong immune-specific response aimed at recognizing and killing tumor cells. It must be capable of maintaining such properties over time and of overcoming tumor immunosuppression. There are several methods for creating a vaccine therapy, all currently undergoing investigation, for example, patients can be injected with one or more peptides of known antigens or else protein components derived from tumor cells (autologous or allogenic). Another method involves the in vitro culture of immunocompetent cells such as dendritic cells, which are then reinjected into the patient. Despite the failure of both adjuvant and advanced therapy in most clinical trials, some encouraging results induced researchers to continue, especially because a strong vaccine-induced immunostimulation seems to correlate positively with clinical outcome, in particular, survival. In the not-too-distant future, gene-expression profiling could help in selecting patients who are likely to benefit from such treatments and could also facilitate the identification of new therapeutic approaches to overcome tumor immunosuppression.
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