Options of Combined Immunotherapy for Cancer by Disease Stage and Goal
At NEO Clinic Tokyo, we offer “combined immunotherapy for cancer,” based on “peptide vaccine therapy,” such as neoantigen peptide vaccine therapy or oncoantigen peptide vaccine therapy, according to the patient’s disease stage and treatment goal.
Individual treatment plans are formulated according to the disease stage and goal of each patient, for example, a current standard therapy received for advanced cancer, unresponsiveness to anticancer drugs, and willingness to prevent recurrence after surgery.
Below are examples of treatment options. The drugs and schedule used for the actual treatment vary depending on the patient.
If you currently receive a standard therapy for advanced cancer
If it is expected to be difficult to obtain a sufficient therapeutic effect with standard therapies (surgery, anticancer drugs, and radiotherapy) for an advanced cancer, “combined immunotherapy for cancer,” primarily focusing on “peptide vaccine therapy,” can be combined with your standard therapy(ies).
When combining it with a standard therapy, the timing and amount of peptide vaccination have a major impact on the therapeutic effect.
Examples of supplementary option to be combined with standard therapy for advanced cancer
The following schedule is an example.
The schedule varies depending on the stage and degree of progression.
- Chemotherapy every 2 weeks (anticancer drugs)
- Peptide vaccination every 2 weeks during an anticancer treatment-free interval
- Administration of cytokines after peptide vaccination depending on the status
| Week 0 | Anticancer drugs |
| Week 1 | Peptide vaccine |
| Week 2 | Anticancer drugs |
| Week 3 | Peptide vaccine Cytokines |
| Week 4 | Anticancer drugs |
| Week 5 | Peptide vaccineCytokines |
| Week 6 | Anticancer drugs |
| Week 7 | Peptide vaccine Cytokines |
| Week 8 | Anticancer drugs |
| Week 9 | Peptide vaccine Cytokines |
| Week 10 | Anticancer drugs |
| Week 11 | Peptide vaccine Cytokines |
| Week 12 | Anticancer drugs |
| Week 13 | Peptide vaccine Cytokines |
If you do not respond to chemotherapy (anticancer drugs)
Cancer cells may increase and become refractory (unresponsive) to anticancer drugs.
The primary factor of unresponsiveness is the defense (resistance) of cancer stem cells (cells that self-replicate cancer cells) to anticancer drugs.
For an advanced cancer that no longer responds to chemotherapy, the “combined immunotherapy for cancer” primarily focusing on “peptide vaccine therapy” can be performed to stop the immunosuppression established by cancer cells.
In addition, the treatment effect can be maximized, if we eliminate cancer cells resistant to drugs by stimulating immune activities and using molecular targeted drugs.
Examples of treatment options for an advanced cancer refractory to chemotherapy (anticancer drugs)
The following schedule is an example.
The schedule varies depending on the stage and degree of progression.
If immunosuppression is not inhibited during the course, additional drugs to inhibit immunosuppression may be administered.
- A molecular targeted drug, an antibody drug, and/or a drug to inhibit immunosuppression, such as anti-inflammatory cytokines, may be administered to inhibit immunosuppression around cancer cells
- Initially, two doses of peptide vaccine are administered. Cytokines are added from the subsequent peptide vaccination.
- Immune checkpoint inhibitor is administered between peptide vaccinations (after every two vaccinations).
| Week 0 | Drugs to inhibit immunosuppression |
| Week 1 | Peptide vaccine |
| Week 2 | Peptide vaccineCytokines |
| Week 3 | Immune checkpoint inhibitor |
| Week 4 | Peptide vaccineCytokines |
| Week 5 | Peptide vaccineCytokines |
| Week 6 | Immune checkpoint inhibitor |
| Week 7 | Peptide vaccineCytokines |
| Week 8 | Peptide vaccineCytokines |
| Week 9 | Immune checkpoint inhibitor |
| Week 10 | Cytokines |
| Week 11 | Cytokines |
| Week 12 | Cytokines |
If you would like to consider prevention of recurrence after surgery
As the relapse prevention treatment after surgery, a standard therapy such as chemotherapy (anticancer drugs) and radiotherapy can be combined with “combined immunotherapy for cancer,” with a primary focus on the use of “peptide vaccine therapy.”
Example of recurrence prevention option (1)
The following schedule is an example.
The schedule varies depending on the stage and degree of progression.
- Peptide vaccination can be initiated within 1 to 2 months after surgery.
- Initially, peptide vaccine is administered every 2 weeks.
- Subsequently, peptide vaccination is administered at monthly intervals.
- Cytokines are administered once every 2 weeks to 1 month depending on the status.
| Month0 | Surgery |
| Month1 | |
| Month2 | Peptide vaccine |
| Peptide vaccine | |
| Month3 | Peptide vaccine |
| Month4 | Peptide vaccine |
| Month5 | Peptide vaccine |
| Month6 | Peptide vaccine |
| Month7 | Peptide vaccine |
| Month8 | Cytokines |
| Month9 | Cytokines |
| Month10 | Cytokines |
| Month11 | Cytokines |
| Month12 | Cytokines |
Example of recurrence prevention option (2)
The following schedule is an example.
The schedule varies depending on the stage and degree of progression.
- Peptide vaccination can be initiated within 1 to 2 months after surgery.
- Initially, peptide vaccine is administered every 2 weeks.
- Subsequently, peptide vaccination is administered at monthly intervals.
- Cytokines can be administered between periods of peptide vaccinations and then every 2 weeks to 1 month after finishing peptide vaccination, depending on the status.
| Month0 | Surgery |
| Month1 | |
| Month2 | Peptide vaccine |
| Peptide vaccine | |
| Month3 | Peptide vaccine |
| Month4 | Peptide vaccine |
| Cytokines | |
| Month5 | Peptide vaccine |
| Cytokines | |
| Month6 | Peptide vaccine |
| Cytokines | |
| Month7 | Peptide vaccine |
| Month8 | Cytokines |
| Month9 | Cytokines |
| Month10 | Cytokines |
| Month11 | Cytokines |
| Month12 | Cytokines |