Gynecological malignancies continue to present significant morbidity and mortality in women notwithstanding current traditional and new targeted treatments. The advent of immunotherapy and its successes in hematologic malignancies, melanoma and lung cancer led to immense interest in exploring its effects in chemoresistant, advanced stage and recurrent gynecologic cancers. The tumor microenviroment is characteristically immunosuppressive to infiltrating cytotoxic T cells. Thus, the goal of immune based therapies is two-fold: overcome this immunosuppression and enhance tumor destruction. In this chapter, we discuss some of the preclinical studies and clinical trials investigating vaccines and other immunotherapies in gynecologic cancer patients. We present key advances in the development of cancer vaccines, adjuvants, immune modulators, adoptive cell therapies for the generation of optimal immunogenicity, and immuno-persistence and the ultimate eradication of resistant, advanced, and recurrent gynecologic cancers.
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