364
Personalized Peptide Vaccine for Prostate Cancer
HER2/neu protein is also expressed in prostate cancer. High-risk prostate cancer
(HRPC) patients demonstrating varying levels of HER2/neu expression have vac-
cinated with E75 peptide plus GM-CSF to prevent postprostatectomy PSA and
clinical recurrences. In a prospective study HER2/neu (E75) vaccine was shown to
prevent or delay recurrences in HRPC patients if completed before PSA recurrence
(Gates et al. 2009 ). A phase I clinical trial of Ii-Key/HER-2/neu hybrid peptide vac-
cine with recombinant GM-CSF as adjuvant in patients with HER-2/neu positive
prostate cancer showed that the vaccine is safe and can induce HER-2/neu-specifi c
cellular immune responses in patients with castrate-sensitive and castrate-resistant
prostate cancer (Perez et al. 2010 ).
A randomized phase II trial of personalized peptide vaccine plus low dose estra-
mustine phosphate (EMP) versus standard dose EMP has been conducted in patients
with castration resistant prostate cancer (Noguchi et al. 2010 ). The combined ther-
apy was well tolerated with increased levels of IgG and cytotoxic-T cell responses
to the vaccinated peptides and resulted in an improvement of progression free sur-
vival as compared to the standard-dose EMP alone.
Personalized Management of Thyroid Cancer
Personalized medicine has a potential for the management of patients with differen-
tiated thyroid cancer (DTC). Majority of patients with DTC have a good prognosis.
Nevertheless the outcome can be optimized by individualization, of the extent of
surgery, the dosage of^131 I therapy and the use of levothyroxine therapy (Luster et al.
2014 ). Newer imaging techniques and targeted molecular therapies such as multi-
targeted kinase inhibitors provide new options for the personalized care of patients
with advanced disease for whom no effective therapies were available previously.
Individualized therapies could reduce adverse effects, including the sometimes
debilitating hypothyroidism that used to be required before initiation of^131 I treat-
ment, and major salivary gland damage, a common and unpleasant side effect of^131 I
therapy. Highly individualized interdisciplinary treatment of patients with DTC
might lead to improved outcomes with reduced severity and frequency of complica-
tions and adverse effects. However, in spite of ongoing research, personalized thera-
pies remain in their infancy.
Future of Cancer Therapy
There are now unprecedented opportunities for the development of improved drugs
for cancer treatment. Most of the genes in the majority of common human cancers
are expected to be defi ned over the next 5 years. This will provide the opportunity
to develop a range of drugs targeted to the precise molecular abnormalities that
10 Personalized Therapy of Cancer