Abstract
Background: The quest for a universal cancer vaccine represents one of the most ambitious goals in biomed ical science. Among tumor-associated antigens, human telomerase reverse transcriptase (hTERT) stands out as an almost universal hallmark of malignancy, reactivated in more than 85% of human cancers but minimally expressed in normal somatic cells.
Main Body: This review synthesizes the molecular rationale, immunological mechanisms, and translational progress of hTERT-based vaccines. Telomerase biology reveals a compelling balance between tumor spec ificity and broad applicability, positioning hTERT as an ideal antigen for both therapeutic and preventive immunization. Clinical development has progressed through three generations, GV1001, GX301, and UV1, each improving immune activation, adjuvant formulation, and safety. Integration with checkpoint inhibitors, cytokine modulators, and novel delivery systems has further enhanced vaccine efficacy. Recent advances in bioinformatics and epitope engineering have enabled the construction of multi-epitope hTERT vaccines, of fering broader HLA coverage and durFuture Directions: As the field transitions toward cancer immunoprevention, hTERT vaccination may serve high-risk populations, such as individuals with hereditary cancer syndromes, chronic inflammation, or en vironmental exposure, by eliminating precancerous cells before malignant transformation. Future research should focus on overcoming immune tolerance, defining biomarkers of protection, and developing cost-effec tive, globally scalable vaccine platforms.
Results: According to Cobas 801 (Roche) standards (0.8 AU/ml normal range), the maximum quantifica tion capacity after 1:10 dilution was 2,500 AU/ml. The antibody response efficiency of the Pfizer-after-Astra Zeneca scheme was 93.88%, while two Pfizer doses achieved 41.38%. The mean increase in antibody titer following the second Pfizer dose was 30.12-fold higher than after the AstraZeneca dose. Age and gender were not statistically significant factors. Statistical comparison using the two-way Wilcoxon test confirmed significant differences between groups (p < 0.01).
Conclusions: hTERT represents a scientifically grounded and translationally viable foundation for a univer sal cancer vaccine. By merging telomerase biology, immunoinformatics, and systems immunology, telomer ase-based immunization has the potential to transform oncology from treatment toward prevention, heralding the era of cancer-free generations.
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