Dendritic cell vaccination for metastatic melanoma: a 14-year monoinstitutional experience

被引:14
|
作者
de Rosa, Francesco [1 ]
Ridolfi, Laura [1 ]
Fiammenghi, Laura [1 ]
Petrini, Massimiliano [1 ]
Granato, Anna M. [1 ]
Ancarani, Valentina [1 ]
Pancisi, Elena [1 ]
Soldati, Valentina [1 ]
Cassan, Serena [1 ]
Bulgarelli, Jenny [1 ]
Framarini, Massimo [3 ]
Tauceri, Francesca [3 ]
Migliori, Giuseppe [4 ]
Brolli, Claudia [5 ]
Gentili, Giorgia [2 ]
Petracci, Elisabetta [2 ]
Nanni, Oriana [2 ]
Riccobon, Angela [1 ]
Ridolfi, Ruggero [1 ]
Guidoboni, Massimo [1 ]
机构
[1] IRCCS, Ist Sci Romagnolo Studio & Cura Tumori IRST, Immunotherapy Cell Therapy & Biobank, I-47014 Meldola, Italy
[2] IRCCS, Ist Sci Romagnolo Studio & Cura Tumori IRST, Unit Biostat & Clin Trials, Meldola, Italy
[3] Morgagni Pierantoni Hosp, Adv Oncol Surg, Forli, Italy
[4] Morgagni Pierantoni Hosp, Blood Transfus Unit, Forli, Italy
[5] Azienda USL Romagna, Blood Prod Factory, Cesena, FC, Italy
关键词
active; cancer vaccines; dendritic cells; immunotherapy; melanoma; RANDOMIZED CONTROLLED-TRIALS; STAGE-IV MELANOMA; UNTREATED MELANOMA; TUMOR RESPONSE; PHASE-II; T-CELLS; SURVIVAL; CANCER; IPILIMUMAB; INTERLEUKIN-2;
D O I
10.1097/CMR.0000000000000356
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Although immunomodulating antibodies are highly effective in metastatic melanoma, their toxicity, related to the activation of T lymphocytes, can be severe. Anticancer vaccines promote a fairly specific response and are very well tolerated, but their effectiveness has yet to be demonstrated. We have been treating patients with advanced melanoma with an autologous dendritic cell vaccine since 2001; to better characterize the safety and efficacy of our product, we designed a retrospective study on all of our patients treated with the vaccine to date. We retrospectively reviewed both case report forms of patients included in clinical trials and medical records of those treated within a compassionate use program. Response was assessed according to the Response Evaluation Criteria In Solid Tumors criteria and toxicity has been graded according to CTCAE 4.0. Although the response rate has been rather low, the median overall survival of 11.4 months and the 1-year survival rate of 46.9% are encouraging, especially considering the fact that data were obtained in a heavily pretreated population and only about one quarter of the patients had received ipilimumab and/or BRAF inhibitors. Multivariate analysis confirmed that the development of an immune response was significantly correlated with a better prognosis (hazard ratio 0.54; P=0.019). The adverse events observed were generally mild and self-limiting. Our analysis confirms the excellent tolerability of our vaccine, making it a potential candidate for combination therapies. As efficacy seems largely restricted to immunoresponsive patients, future strategies should aim to increase the number of these patients.
引用
收藏
页码:351 / 357
页数:7
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