Efficacy of cancer vaccines in selected gynaecological breast and ovarian cancers: A 20-year systematic review and meta-analysis.

BACKGROUND: Therapeutic cancer vaccination is an area of interest, even though promising efficacy has not been demonstrated so far. DESIGN: A systematic review and meta-analysis was conducted to evaluate vaccines' efficacy on breast cancer (BC) and ovarian cancer (OC) patients. Our search was based on the PubMed electronic database, from 1st January 2000 to 4th February 2020. OBJECTIVE: response rate (ORR) was the primary end-point of interest, while progression-free survival (PFS), overall survival (OS) and toxicity were secondary end-points. Analysis was performed separately for BC and OC patients. Pooled ORRs were estimated by fixed or random effects models, depending on the detected degree of heterogeneity, for all studies with more than five patients. Subgroup analyses by vaccine type and treatment schema as well as sensitivity analyses, were implemented. RESULTS: Among 315 articles initially identified, 67 were eligible for our meta-analysis (BC: 46, 1698 patients; OC: 32, 426 patients; where both BC/OC in 11). Dendritic-cell and peptide vaccines were found in more studies, 6/10 BC and 10/13 OC studies, respectively. In our primary BC analysis (21 studies; 428 patients), the pooled ORR estimate was 9% (95%CI[5%,13%]). The primary OC analysis (12 studies; 182 patients), yielded pooled ORR estimate of 4% (95%CI[1%,7%]). Similar were the results derived in sensitivity analyses. No statistically significant differences were detected by vaccine type or treatment schema. Median PFS was 2.6 months (95% confidence interval (CI)[1.9,2.9]) and 13.0 months (95%CI[8.5,16.3]) for BC and OC respectively, while corresponding median OS was 24.8 months (95%CI[15.0,46.0]) and 39.0 months (95%CI[31.0,49.0]). In almost all cases, the observed toxicity was only moderate. CONCLUSION: Despite their modest results in terms of ORR, therapeutic vaccines in the last 20 years display relatively long survival rates and low toxicity. Since a plethora of different approaches have been tested, a better understanding of the underlying mechanisms is needed in order to further improve vaccine efficacy.

Effects of multifunctional cross-linkers on rheology and adhesion of soft nanostructured materials.

We investigate the nanostructure, the rheology and the adhesion of soft supramolecular materials elaborated by blending monofunctional and multifunctional poly(isobutene) (PIB) chains. Monofunctional PIB chains (PIBUT) are linear and unentangled polymer chains (Mn ≈ 3 kg mol-1) functionalized in the middle by a bis-urea interacting moiety, able to self-associate by four hydrogen bonds. Covalent coupling of monofunctional PIB allows us to synthesize longer chains bearing two or three interacting moieties. These chains are then added to monofunctional PIB to prepare blends containing up to 10% of multifunctional PIB (M-PIBUT). The influence of M-PIBUT on the supramolecular nanostructure, which results from the self-assembly of stickers, is studied by Atomic Force Microscopy and Small Angle X-ray Scattering at room temperature. Multifunctional and monofunctional chains are shown to interact with each other to form bundles of rod-like aggregates. The consequences of these interactions on the rheology of the blends were studied by shear tests in the linear and non linear regimes, below and above the order-disorder transition temperature. A pronounced strengthening effect of M-PIBUT is observed at room temperature: the supramolecular blends become more elastic and are more resistant to creep with increasing concentration of M-PIBUT. The effects of M-PIBUT on the nanostructure and the rheology suggest that M-PIBUT, which can link with more than one supramolecular aggregate, plays the role of a physical cross-linker. The impact of these supramolecular cross-linkers on the adhesion of the blends is studied by probe-tack tests and discussed by analyzing the in situ deformation through the debonding images.