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Vaccine therapy for small cell lung cancer.

One novel approach to the treatment of lethal residual disease in patients with small cell lung cancer (SCLC) relies on the induction of a host-immune response to attack chemoresistant tumor cells. Because of its neuroectodermal origin, SCLC has a number of specific antigens that could be capitalized on as immune targets. This article reviews two vaccine strategies currently in clinical study. The anti-idiotype vaccine to the GD3 ganglioside, BEC-2, has recently been tested in a phase III trial. In this trial, patients with SCLC who had completed initial chemotherapy were randomized to observation or vaccination with BEC-2 plus bacillus Calmette-Guerin adjuvant. A series of other trials have established the immunogenicity of several keyhole limpet hemocyanin conjugate vaccines relevant to SCLC, including GM2, Globo H, fucosyl GM1, and polysialic acid. To optimize an immune response against a broad range of tumor phenotypes, these components will be combined into a polyvalent vaccine. A randomized phase II trial of this polyvalent vaccine is planned to start in 2004.