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A small pilot study raises hopes that personalized cancer vaccines might prove safer and more effective than immune-based therapies already in use or further along in development. In a paper published online in Nature on Wednesday, scientists reported that all six melanoma patients who received an experimental, custom-made vaccine seemed to benefit: their tumors did not return after treatment.

Researchers not involved in the study praised its results, but with caveats. The scientists “did a beautiful job,” said MD Anderson Cancer Center’s Greg Lizee, an expert in tumor immunology, who called the results “very encouraging.” But because the study did not include a comparison group of patients who received standard treatment and not the vaccine, he cautioned, “it’s not completely proved yet that the lack of [cancer] recurrence was due to the vaccine.”

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The first cancer immunotherapies were drugs such as pembrolizumab (Keytruda) and ipilimumab (Yervoy), which interfere with molecules that block immune cells from attacking a tumor. But that’s an effective strategy only if any such immune cells are trying to reach the tumor; if not, clearing a path for something that’s nowhere to be found doesn’t help. That’s a big reason why immunotherapy drugs help in only a minority of cancers: For many tumors, immune cells are AWOL.

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