Science – 15 May 2015

15 May 2015 vol 348, issue 6236, pages 729-832
In Depth
Infectious Diseases
Ebola survivors fight back in plasma studies
Martin Enserink*
In the Guinean capital, Conakry, 90 people have so far been treated in a clinical trial that aims to seek whether plasma from Ebola survivors can help patients. Animal studies of similar therapies had yielded mixed results, and the findings of a small human study in 1995 were ambiguous. The study aims to recruit 130 patients, but enrollment has ground to a halt because the last Ebola patient in Conakry was discharged on 28 April. Results are expected later this year, but researchers acknowledge that they will be difficult to interpret because the study has no control arm.

Policy Forum
Public Health
Linking funds to actions for global health emergencies
C. J. Standley, E. M. Sorrell, S. Kornblet, A. Vaught, J. E. Fischer, R. Katz*
Author Affiliations
Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
The failings of the international community’s response to the Ebola virus disease outbreak in West Africa underscore the need for new mechanisms for governance and mobilization of resources for timely, coordinated responses to public health threats (1). Creating a global finance mechanism, ideally tied to existing global health frameworks, is a first step. The World Bank recently announced it would create a Pandemic Emergency Facility (PEF). The next necessary element is a trigger to release those funds to support rapid and effective responses during early phases of a public health event. With the World Health Assembly convening soon, we suggest how the World Health Organization’s (WHO’s) International Health Regulations (IHR) present such an initiator.

Cancer Immunotherapy
Neo approaches to cancer vaccines
Lélia Delamarre, Ira Mellman, Mahesh Yadav
Author Affiliations
Genentech, South San Francisco, CA 94080, USA.
The recent success of cancer immunotherapies is rapidly changing the face of both cancer care and cancer biology. The excitement has been driven by various antibodies that block so-called “immune checkpoints” to enhance antitumor immune responses (1). Although this approach has produced durable responses for patients across a variety of tumor types, it is also the case that only a minority of patients benefit from these agents. It seems likely that among patients who do not respond or respond poorly to immunotherapies, there will be individuals who lack preexisting antitumor T cell responses. In principle, this situation can be addressed with antitumor vaccines, a strategy that has yet to yield much success despite decades of effort. The recent finding that tumor-specific mutations (neoantigens) may drive potent antitumor responses has provided hope and prompted renewed interest in the field (2). On page 803 of this issue, Carreno et al. (3) report, in a first proof of concept study, that CD8 T cell responses to tumor neoantigens can be enhanced through vaccination in melanoma patients.