Personalized therapy is directed at obtaining maximal therapeutic effect on diseased tissue with minimal off-target side effects. Many classes of therapeutics have attempted to reach this ideal, only to fall well short. Therapeutic vaccines represent a novel class of therapies that can induce a dynamic immune response that, in theory, can continue to adapt and expand following initiation of vaccination. This adaptability, through epitope spreading or antigen cascade, can continuously refine a therapeutic immune response, making it more relevant to the patient's tumor. This active, dynamic, iterative process can continue long after the vaccine course has been completed. Recent clinical trials have provided further insight into the clinical activity of therapeutic vaccines, and offer guidance on clinical expectations following vaccine. The ongoing active sculpting of the immune response, along with the lack of significant side effects, uniquely positions therapeutic vaccines as perhaps the ultimate in personalized therapy.
Keywords: antigen cascade; antigen spreading; cancer vaccine; epitope spreading; immunotherapy; individualized therapy; personalized medicine.