TITLE:
Clinical and Immunological Effects in Patients with Advanced Non-Small Cell Lung-Cancer after Vaccination with Dendritic Cells Exposed to an Allogeneic Tumor Cell Lysate
AUTHORS:
Lotte Engell-Noerregaard, Pia Kvistborg, Mai-Britt Zocca, Ayako W. Pedersen, Mogens H. Claesson, Anders Mellemgaard
KEYWORDS:
NSCLC; Dendritic Cells; Vaccination; Tumor Lysate
JOURNAL NAME:
World Journal of Vaccines,
Vol.3 No.2,
May
22,
2013
ABSTRACT:
Background: We evaluated the clinical and immunological effects of dendritic
cell (DC) vaccination of patients with NSCLC. Autologous DCs were pulsed with a MAGE
containing allogeneic melanoma cell lysate (MelCancerVac?, Dandrit
Biotech,Copenhagen,Denmark).
Imiquimod cream, proleukin and celecoxib were used as adjuvants to the
vaccines. The objective of the study was to evaluate specific T cell response
in vitro by IFNg EliSpot. Secondary objectives were overall survival, response and
quality of life (QoL). Results: Twenty-two patients initiated the vaccination program consisting of ten
vaccinations. Seven patients remained in stable disease (SD) three months after
the first vaccination. After ten vaccinations (six months), four patients still
showed SD and continued vaccinations on a monthly basis. These four patients
received a total of 12, 16, 26 and 35 vaccinations, respectively. Five patients
showed an unexpectedly prolonged survival. The treatment was well tolerated and
only minor adverse events were reported. Quality of life did not change during
the study period. In four of the seven patients with SD, vaccine-specific T
cells were detected by IFNγ EliSpot
assays, whereas only one patient with progressive disease (PD) showed vaccine-specific
responses. Conclusion: This
DC-based vaccine trial has indicated a correlation between vaccine-specific
immunity and sustained SD. Furthermore, we observed an unexpectedly prolonged
survival in some patients, which may indicate delayed effect of DC vaccination
after completion of the treatment. A prospective randomized phase-IIb or -III
is needed to further evaluate the use of MelCancerVac? vaccine
treatment in patients with progressive NSCLC.