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World Allergy Organization
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WAO Medical Book Review

Posted: June 2009

Cancer Vaccines and Tumor Immunity
Orentas RJ; Hodge JW; and Johnson B. - Editors
2008 Wiley-Liss
ISBN: 978-0-470-07474-9 (hardcover); 978-0-470-17010-6 (e-book)
Price $125 USD

Available from Wiley:
Hardcover
E-book download

Reviewer:
Veronica A Preda, MB BS BSc (Hon)
Campbelltown Hospital
Sydney, New South Wales
and
Skin & Cancer Foundation Australia
Darlinghurst, New South Wales
Australia

Description
This text provides a comprehensive overview of the currently explored areas in the development of cancer immunotherapy, namely the ability of the immune system to recognize and eliminate malignant cells. It is a compilation by authors who are leaders in their fields and makes sense of the exponential expansion of knowledge in immune mechanisms, tumor growth and therefore potential for control. The authors translate the basic scientific discoveries into tangible human research and experimentation, leading on to the current frontier of increasing clinical application. New avenues for further clinical studies are discussed, providing promise for the future.

Purpose
The purpose is to provide the oncology focused researcher, academic and clinician with a concise overview of the emerging field of cancer vaccines and tumor immunity. Input from a multitude of sources in this diverse field brings the reader to the current crossroad in our understanding of malignancies and basis for therapeutic manipulation. Fundamentally the basis of human cancer and host-tumor interactions are explored with a focus on each of the potential therapeutic pathways. Central to this theme is effective vaccination requiring the identification of appropriate protein/peptide targets and the countering of the detrimental immune regulatory T cell response.

Audience
Research minded immunologists, oncologists, medical researchers and colleagues with an interest in the latest developments which are rapidly adding to our armamentarium to manage malignancies.

Features
This text is a bridge describing the pioneering work that has already been integrated into clinical usefulness, with the exploration of the major areas of cancer vaccination and immunotherapy. The fascinating historical background of immunotherapy in cancer is also mentioned, including the ground-breaking role of Bacillus Calmett-Guerin (BCG) therapy in bladder cancer.

There are in four main areas to the text. The first is adjuvant therapy enhancing the endogenous immune response. It draws on current knowledge, raising the increasingly recognised role of the complex interplay of both the innate and adaptive immune system with for example toll-like receptors and enhancement of vaccination. Second is antigen-specific therapy with novel presentation of peptide and protein antigens. Examples in this research domain include melanoma, breast and cervical cancer. Polypeptide based therapy and EBV associated malignancy is described. Thirdly cell-based therapy to induce specific tumor immunity is discussed. Some applications include therapeutic monoclonal antibodies potentiating tumor immunity in breast cancer or depletion of regulatory T cells post haemopoietic stem cell transplant promoting T cell reconstitution. The text concludes with a fourth area detailing effective clinical responses and monitoring strategies.

Assessment
Technological advances have allowed greater flexibility in the ability to deliver various vaccines as well as allowing the potential to manipulate the immune system for therapeutic outcome. This book emphasizes the rapid change and dynamic nature of this area of immunological based oncology research, including examples of recent advances in cervical cancer and melanoma vaccination. It is an excellent resource. Despite the complexity of this topic it has been broken down into digestable summaries of the latest promises of potential control of cancer and the quest for curative therapy with targeted treatments.