Genitourinary (Non-Prostate) Cancers: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Following coverage from The ASCO Post, Emily Lemke, DNP, AGPCNP-BC, AOCNP®, of Medical College of Wisconsin Cancer Center, comments on an adjuvant trial of a checkpoint inhibitor for clear cell renal cell carcinoma (RCC), real-world data comparing first-line platinum regimens for patients with metastatic urothelial carcinoma, and combination regimens for RCC.

Adjuvant Selection for Influenza and RSV Prefusion Subunit Vaccines

Subunit vaccines exhibit favorable safety and immunogenicity profiles and can be designed to mimic native antigen structures. However, pairing with an appropriate adjuvant is imperative in order to elicit effective humoral and cellular immune responses. In this study, we aimed to determine an optimal adjuvant pairing with the prefusion form of influenza haemagglutinin (HA) or respiratory syncytial virus (RSV) fusion (F) subunit vaccines in BALB/c mice in order to inform future subunit vaccine adjuvant selection. We tested a panel of adjuvants, including aluminum hydroxide (alhydrogel), QS21, Addavax, Addavax with QS21 (AdQS21), and Army Liposome Formulation 55 with monophosphoryl lipid A and QS21 (ALF55). We found that all adjuvants elicited robust humoral responses in comparison to placebo, with the induction of potent neutralizing antibodies observed in all adjuvanted groups against influenza and in AdQS21, alhydrogel, and ALF55 against RSV. Upon HA vaccination, we observed that none of the adjuvants were able to significantly increase the frequency of CD4+ and CD8+ IFN-γ+ cells when compared to unadjuvanted antigen. The varying responses to antigens with each adjuvant highlights that those adjuvants most suited for pairing purposes can vary depending on the antigen used and/or the desired immune response. We therefore suggest that an adjuvant trial for different subunit vaccines in development would likely be necessary in preclinical studies.