Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a review

Therapeutic cancer vaccines aim to generate a robust immune response against tumour-associated antigens (TAAs) or tumour-specific antigens. While their safety is well established, their efficacy as monotherapy remains limited due to factors such as self-tolerance to TAAs and the immunosuppressive tu...

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Main Authors: Igor Gomez-Randulfe, Helen Lavender, Stefan Symeonides, Fiona Blackhall
Format: Article
Language:English
Published: SAGE Publishing 2025-02-01
Series:Therapeutic Advances in Medical Oncology
Online Access:https://doi.org/10.1177/17588359251316988
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author Igor Gomez-Randulfe
Helen Lavender
Stefan Symeonides
Fiona Blackhall
author_facet Igor Gomez-Randulfe
Helen Lavender
Stefan Symeonides
Fiona Blackhall
author_sort Igor Gomez-Randulfe
collection DOAJ
description Therapeutic cancer vaccines aim to generate a robust immune response against tumour-associated antigens (TAAs) or tumour-specific antigens. While their safety is well established, their efficacy as monotherapy remains limited due to factors such as self-tolerance to TAAs and the immunosuppressive tumour microenvironment. Combining cancer vaccines with systemic anticancer therapies (SACTs) offers a promising strategy to improve efficacy. However, the optimal timing and combination with immune checkpoint inhibitors (ICIs) and chemotherapy to enhance immunogenicity are not yet fully understood. This review aims to assess the evidence regarding the immunogenicity of antiviral and anticancer vaccines when combined with SACTs, including chemotherapy and ICIs, with a particular focus on the timing of vaccine administration relative to SACT. Additionally, we evaluate the impact of steroids on immunogenicity. Our findings suggest that the timing of vaccine administration is critical, with improved immunogenic responses observed when vaccines are administered at nadir (15 days post-chemotherapy). Certain chemotherapies, such as low-dose metronomic cyclophosphamide and paclitaxel, demonstrate potential for immunomodulation, enhancing T-cell responses when combined with vaccines. Conversely, steroids may reduce immunogenicity. The combination of ICIs with cancer vaccines shows evidence of a synergistic effect, with concurrent administration generally yielding better outcomes than sequential approaches. Prospective trials exploring various timings and sequences are essential to optimize the efficacy of anticancer vaccines.
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spelling doaj-art-3252279e12fd4e08af7d2bf9ec53b9ec2025-08-20T03:04:44ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592025-02-011710.1177/17588359251316988Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a reviewIgor Gomez-RandulfeHelen LavenderStefan SymeonidesFiona BlackhallTherapeutic cancer vaccines aim to generate a robust immune response against tumour-associated antigens (TAAs) or tumour-specific antigens. While their safety is well established, their efficacy as monotherapy remains limited due to factors such as self-tolerance to TAAs and the immunosuppressive tumour microenvironment. Combining cancer vaccines with systemic anticancer therapies (SACTs) offers a promising strategy to improve efficacy. However, the optimal timing and combination with immune checkpoint inhibitors (ICIs) and chemotherapy to enhance immunogenicity are not yet fully understood. This review aims to assess the evidence regarding the immunogenicity of antiviral and anticancer vaccines when combined with SACTs, including chemotherapy and ICIs, with a particular focus on the timing of vaccine administration relative to SACT. Additionally, we evaluate the impact of steroids on immunogenicity. Our findings suggest that the timing of vaccine administration is critical, with improved immunogenic responses observed when vaccines are administered at nadir (15 days post-chemotherapy). Certain chemotherapies, such as low-dose metronomic cyclophosphamide and paclitaxel, demonstrate potential for immunomodulation, enhancing T-cell responses when combined with vaccines. Conversely, steroids may reduce immunogenicity. The combination of ICIs with cancer vaccines shows evidence of a synergistic effect, with concurrent administration generally yielding better outcomes than sequential approaches. Prospective trials exploring various timings and sequences are essential to optimize the efficacy of anticancer vaccines.https://doi.org/10.1177/17588359251316988
spellingShingle Igor Gomez-Randulfe
Helen Lavender
Stefan Symeonides
Fiona Blackhall
Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a review
Therapeutic Advances in Medical Oncology
title Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a review
title_full Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a review
title_fullStr Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a review
title_full_unstemmed Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a review
title_short Impact of systemic anticancer therapy timing on cancer vaccine immunogenicity: a review
title_sort impact of systemic anticancer therapy timing on cancer vaccine immunogenicity a review
url https://doi.org/10.1177/17588359251316988
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