JAMA experts explain how cancer vaccines work and what still blocks them

Experts speaking in a JAMA lecture explain that cancer vaccines combine an immunogenic protein payload, an adjuvant and a delivery vehicle to activate innate immunity and generate long-lived T-cell memory. Preventive antiviral vaccines such as those for HPV and HBV already work, and approved therapeutic options include Sipuleucel-T for prostate cancer and an oncolytic virus for melanoma, but none cure disease. The main obstacles are adjuvants that induce antibodies rather than type 1 cytotoxic T-cell responses and the difficulty of clinical trials, with surrogate endpoints for laboratory efficacy hoped for within 5 to 8 years.