Ever since the use of aluminium hydroxide (alum) as a potent adjuvant,
there has been a colossal rise in the available adjuvants of varied nature for vaccine
development. We now have come to a point where we know that some of the immune
components such as cytokines are themselves associated with adjuvant properties.
However, despite hundreds of well-designed pre-clinical candidates obtained after
decades of research, only a handful of vaccine adjuvants have been approved and
licensed for human use. This may be attributed to the complexity and the difficulty in
designing adjuvants that are safe, potent and economically viable. However recent
advances in our understanding of innate immunity, the immune response pathways and
the mechanism of adjuvant interactions has led to better adjuvant formulations. For
cancer, the success stories of treatment through immunotherapy were not as significant
as that of chemo- or radiotherapy. However, vaccine development research has got an
enormous attention after the US FDA approval of various preventive cancer vaccines
such as Gardasil (Merck), Cervarix (Glaxosmithkline) and the therapeutic vaccine
Sipulencel-T (Provenge). Approval of these vaccines has invigorated the use of cellular
immunotherapy as an effective alternate method for the treatment of cancer and has
provided support for renewed interest and attention which the development of new
therapeutic cancer vaccines deserves. The present chapter discusses the role,
mechanism of action, current clinical scenario of new cancer vaccine adjuvants,
application of their molecularly defined formulations to new generation cancer
vaccines and the future challenges, for the benefit of a varied audience.
Keywords: Adjuvant formulation, Alum, AS03, AS04, BCG, BSA, Cancer
vaccine, Cellular response, CLRs, Cytokines, Dendritic cells, Humoral response,
Immunotherapy, Immunization, Inflammasome, MF59, New generation vaccines,
NLRs, Pattern recognition receptors, Potential adjuvants, TLRs, Virus-like
particles.
