PDF(Pubmed)
Abstract：
Advanced pancreatic cancer is one of the prominent contributors to cancer-related mortality globally. Chemotherapy, especially gemcitabine, is generally used for the treatment of advanced pancreatic cancer. Despite the treatment, the fatality rate for advanced pancreatic cancer is alarmingly high. Thus, the dire need for better treatment alternatives has drawn focus to cancer vaccinations. The Wilms tumor gene (WT1), typically associated with Wilms tumor, is found to be excessively expressed in some cancers, such as pancreatic cancer. This characteristic feature is harvested to develop cancer vaccines against WT1. This review aims to systematically summarize the clinical trials investigating the efficacy and safety of WT1 vaccines in patients with advanced pancreatic cancer. An extensive literature search was conducted on databases Medline, Web of Science, ScienceDirect, and Google Scholar using the keywords \"Advanced pancreatic cancer,\" \"Cancer vaccines,\" \"WT1 vaccines,\" and \"Pulsed DC vaccines,\" and the results were exclusively studied to construct this review. WT1 vaccines work by introducing peptides from the WT1 protein to trigger an immune response involving cytotoxic T lymphocytes via antigen-presenting cells. Upon activation, these lymphocytes induce apoptosis in cancer cells by specifically targeting those with increased WT1 levels. WT1 vaccinations, which are usually given in addition to chemotherapy, have demonstrated clinically positive results and minimal side effects. However, there are several challenges to their widespread use, such as the immunosuppressive nature of tumors and heterogeneity in expression. Despite these limitations, the risk-benefit profile of cancer vaccines is encouraging, especially for the WT1 vaccine in the treatment of advanced pancreatic cancer. Considering the fledgling status of their development, large multicentric, variables-matched, extensive analysis across diverse demographics is considered essential.
摘要：
晚期胰腺癌是全球癌症相关死亡率的主要贡献者之一。化疗,尤其是吉西他滨,一般用于晚期胰腺癌的治疗。尽管有治疗,晚期胰腺癌的死亡率高得惊人。因此，迫切需要更好的治疗替代方案，这引起了人们对癌症疫苗接种的关注。Wilms肿瘤基因（WT1），通常与Wilms肿瘤有关，被发现在某些癌症中过度表达，比如胰腺癌。收集该特征以开发针对WT1的癌症疫苗。本文旨在系统总结研究WT1疫苗在晚期胰腺癌患者中的疗效和安全性的临床试验。在Medline数据库上进行了广泛的文献检索，WebofScience,ScienceDirect,和谷歌学者使用关键字\“晚期胰腺癌，\"\"癌症疫苗，\"\"WT1疫苗，“和”脉冲DC疫苗，“并对结果进行了专门研究，以构建这篇综述。WT1疫苗通过从WT1蛋白引入肽以经由抗原呈递细胞触发涉及细胞毒性T淋巴细胞的免疫应答来工作。激活后，这些淋巴细胞通过特异性靶向WT1水平升高的细胞来诱导癌细胞凋亡。WT1疫苗接种，通常除了化疗之外，已经证明了临床上的积极结果和最小的副作用。然而,它们的广泛使用有几个挑战，如肿瘤的免疫抑制性质和表达的异质性。尽管有这些限制,癌症疫苗的风险-收益特征令人鼓舞，特别是WT1疫苗在晚期胰腺癌的治疗。考虑到它们的发展还处于起步阶段，大型多中心，变量匹配，跨不同人口统计学的广泛分析被认为是必不可少的。
