Enhancing the efficacy of cancer vaccines in urologic oncology: new directions.

Immunotherapeutic interventions have long been utilized in urologic oncology for the treatment of metastatic renal cell or superficial transitional cell carcinoma. Most recently, the first active specific immunotherapeutic approach, a cancer vaccine, has passed the final phase of human testing and its approval by the FDA is pending. However, evidence suggests that the full protective and therapeutic potential of cancer vaccines has not yet been achieved. Through multiple mechanisms, tumors promote conditions in the tumor-bearing host that mitigate or even eliminate the vaccine-induced antitumor response. Restoration of the impaired immune function is, therefore, imperative for achieving optimum vaccine efficacy. Targeted pharmacological interventions are capable of overcoming tumor-mediated immunosuppression, and thereby enable cancer vaccination to reach its full therapeutic potential.