Currently, the backbone of therapy for metastatic disease is cytotoxic chemotherapy, along with the recent addition of targeted therapy based on molecular markers with KRAS testing. Despite the improvement in survival for metastatic colon cancer, newer agents are still needed. The clinical activity of TroVax in metastatic colon cancer has been studied in a small number of clinical trials. There is evidence that supports the vaccine's ability to induce humoral and cellular responses, as demonstrated by positive 5T4 and MVA-specific antibody titers and cellular proliferation assays. Future strategies should focus on investigating the immunomodulatory effects of chemotherapy in conjunction with TroVax, understanding the optimal dosing and schedule of the combination, and examining potential predictive biomarkers to determine which patients may benefit from immunotherapy from those who do not.
Keywords: 5T4-antigen; ADCC, Antibody-dependent cell-mediated cytotoxicity; CEA, Carcinoembryonic antigen; CRC, Colorectal cancer; DT, Doubling time; EBNA-1, Epstein Barr-Virus nuclear antigen-1; EGFR, Epidermal growth factor receptor; HRPC, Hormone refractory prostate cancer; IHC, Immunohistochemoical; ITT, Intention to treat; LMP-2, Latent membrane protein-2 antigens; MSKCC, Memorial Sloan-Kettering Cancer Center; MVAs, Modified vaccinia Ankara; NSCLC, Non-small cell lung cancer; OS, Overall survival; PD-1, Programmed death 1 receptor; PD-L1, Programmed-death ligand 1; PFS, Progression free survival; PMNs, Peripheral blood mononuclear cells; RCC, Renal cell carcinoma; T-FOLFIRI, Trovax and FOLFIRI; T-FOLFOX, Trovax and FOLFOX; TAAs, Tumor-associated antigens; TILs, Tumor-infiltrating lymphocytes; TTP, Time to progression; TroVax; VEGF, Vascular-endothelial growth factor; immunotherapy; mCRC, Metastatic colon cancer; mRCC, Metastatic renal cell carcinoma; metastatic colon cancer; modified vaccinia Ankara.