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It outlines how limited success of chemoprevention may reflect drug exposure timing, colon penetration, and adherence constraints. The article argues that antigen-directed polyp vaccines could generate durable immune responses, with primed antigen-specific T cells trafficking to antigen-expressing sites and using immunologic memory to sustain activity while restricting toxicity. It summarizes current vaccine approaches and translation challenges to clinical use.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/vaccines-for-cancer-interception-in-familial-adenomatous-polyposis-review/375833/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/vaccines-for-cancer-interception-in-familial-adenomatous-polyposis-review/375833.png","ImageObject",300,407,{"name":92,"@type":93},"Jake","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What causes familial adenomatous polyposis (FAP)?","Question",{"text":112,"@type":113},"FAP is caused by germline mutations in the adenomatous polyposis coli (APC) gene and is inherited in an autosomal dominant pattern. It leads to hundreds of adenomas in the rectum and colon starting in the teenage years.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why have chemoprevention approaches not eliminated colorectal cancer risk in FAP?",{"text":117,"@type":113},"Chemoprevention has reduced polyp burden but has not reduced colorectal cancer risk. The review attributes possible reasons to limited drug exposure during key periods, limited drug penetrance in the colon, and patient adherence to daily dosing and side effects.",{"name":119,"@type":110,"acceptedAnswer":120},"How do polyp-directed vaccines aim to control disease progression in FAP?",{"text":121,"@type":113},"Vaccines targeting antigens expressed in FAP lesions are proposed to generate durable immune responses. 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Pascale National Cancer Institute Foundation (IRCCS), Italy  \nREVIEWED BY  \nDongbo Jiang,  \nAir Force Medical University, China Ramireddy Bommireddy,  \nEmory University, United States  \n*CORRESPONDENCE  \nMary L. Disis  \n [ndisis@uw.edu](ndisis@uw.edu)  \nRECEIVED 08 November 2024  \nACCEPTED 03 January 2025  \nPUBLISHED 29 January 2025  \nCITATION  \nJohnson DE and Disis ML (2025)  \nVaccines for cancer interception in familial adenomatous polyposis.  \nFront. Immunol. 16:1525157 .  \ndoi: 10.3389/fimmu.2025.1525157  \nCOPYRIGHT  \n© 2025 Johnson and Disis. This is an openaccess article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nVaccines for cancer interception in familial adenomatous polyposis  \nDavid E. Johnson 1 and Mary L. Disis 2*  \n1 Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA, United States, 2 UW Medicine Cancer Vaccine Institute, University of Washington, Seattle, WA, United States  \nFamilial adenomatous polyposis (FAP) is an inherited autosomal dominant disorder caused by germline mutations in the adenomatous polyposis coli (APC) gene. FAP is associated with the development of hundreds of adenomasin the small and large intestines of individuals starting in the teenage years with a near 100% risk of developing colorectal cancer by adulthood. Eventually polyps develop throughout the gastrointestinal tract. Chemoprevention approaches have been somewhat successful in reducing polyp burden, but have not reduced the risk of the development of colorectal cancer or other cancers. The lack of efficacy of more standard drug approaches may be due to limited exposure to the agent only to specific periods while the drug is being metabolized, limited drug penetrance in the colon, and patient adherence to daily dosing and drug side effects. The success of immune therapy for the treatment of invasive cancer has led to research focused on the use of immune based approaches for polyp control in FAP, specifically polyp directed vaccines. Vaccines targeting antigens expressed in FAP lesions may be a superior method to control polyp burden and prevent disease progression as compared to classic chemoprevention drugs. A limited number of vaccines can be administered over a short period of time to generate a lasting immune response. Appropriately primed antigen specific T-cells can traffic to any site in the body where antigen is expressed, recognize, and eliminate the antigen expressing cell. Immunologic memory will allow the immune response to persist and the specificity of the immune response will limit toxicity to the targeted polyp. This review will examine the current state of vaccines directed against FAP lesions and highlight the challenges and opportunities of translating vaccines for cancer interception in FAP to the clinic.  \nKEYWORDS  \nvaccine, familial adenomatous polyposis (FAP), chemoprevention, cancer interception, T-cells  \nFrontiers in Immunology 01 [frontiersin.org](frontiersin.org)  \nIntroduction  \nFamilial adenomatous polyposis (FAP) is an inherited autosomal dominant disorder caused by germline mutations in the adenomatous polyposis coli (APC) gene. The disorder is characterized by the development of hundreds of adenomas in the rectum and colon of individuals starting in the teenage years with a near 100% risk of developing colorectal cancer (CRC) by adulthood. FAP is the most common adenomatous polyposis syndrome and is responsible for approximately 1% of all CRC diagnoses. Although FAP is","cbCaibVGacCzsz16","https://ap.wps.com/l/cbCaibVGacCzsz16","pdf",400466,"English","# Introduction\n# Treatment of FAP","[{\"question\":\"What causes familial adenomatous polyposis (FAP)?\",\"answer\":\"FAP is caused by germline mutations in the adenomatous polyposis coli (APC) gene and is inherited in an autosomal dominant pattern. It leads to hundreds of adenomas in the rectum and colon starting in the teenage years.\"},{\"question\":\"Why have chemoprevention approaches not eliminated colorectal cancer risk in FAP?\",\"answer\":\"Chemoprevention has reduced polyp burden but has not reduced colorectal cancer risk. The review attributes possible reasons to limited drug exposure during key periods, limited drug penetrance in the colon, and patient adherence to daily dosing and side effects.\"},{\"question\":\"How do polyp-directed vaccines aim to control disease progression in FAP?\",\"answer\":\"Vaccines targeting antigens expressed in FAP lesions are proposed to generate durable immune responses. Primed antigen-specific T cells can traffic to any antigen-expressing site, recognize and eliminate antigen-expressing cells, and immunologic memory helps sustain the response while specificity may limit toxicity.\"}]","Vaccines for cancer interception in familial adenomatous polyposis - Review | PDF",1790216268,23]