| Title | Clinical and Immunologic Effects of Intranodal Autologous Tumor Lysate-Dendritic Cell Vaccine with Aldesleukin (Interleukin 2) and IFN-{alpha}2a Therapy in Metastatic Renal Cell Carcinoma Patients. | | Author(s) | Schwaab T, Schwarzer A, Wolf B, Crocenzi TS, Seigne JD, Crosby NA, Cole BF, Fisher JL, Uhlenhake JC, Mellinger D, Foster C, Szczepiorkowski ZM, Webber SM, Schned AR, Harris RD, Barth RJ, Heaney JA, Noelle RJ, Ernstoff MS | | Institution | Authors' Affiliations: Medical Oncology Immunotherapy Group, Section of Hematology/Oncology, Department of Medicine, Cell Therapy Center, Department of Pathology, Section of Urology, Departments of Surgery, Diagnostic Radiology, Microbiology and Immunology, Section of Biostatistics and Epidemiology, Department of Family and Community Medicine, and Immunotherapy Program, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Dartmouth Medical School, Hanover, New Hampshire; and Earle A. Chiles Cancer Research Center, Portland, Oregon. | | Source | Clin Cancer Res 2009 Jul 21. | | Abstract | PURPOSE: To evaluate the clinical and immunologic outcomes of DC (dendritic cell) vaccine with interleukin (IL)-2 and IFN-alpha 2a in metastatic renal cell carcinoma patients. EXPERIMENTAL
DESIGN: Eighteen consented and eligible patients were treated. Peripheral blood monocytes were cultured ex vivo into mature DCs and loaded with autologous tumor lysate. Treatment consisted of five cycles of intranodal vaccination of DCs (1 x 10(7) cells/1 mL Lactated Ringer's solution), 5-day continuous i.v. infusion of IL-2 (18MiU/m(2)), and three s.c. injections of IFN-alpha 2a (6MiU) every other day. Response Evaluation Criteria in Solid Tumors criteria were used for disease assessment. Correlative immunologic end points included peripheral blood lymphocyte cell phenotype and function as well as peripheral blood anti-renal cell carcinoma antibody and cytokine levels.
RESULTS: All patients received between two and five treatment cycles. Toxicities consisted of known and expected cytokine side effects. Overall objective clinical response rate was 50% with three complete responses. Median time to progression for all patients was 8 months, and median survival has not been reached (median follow up of 37+ months). Treatment-related changes in correlative immunologic end points were noted and the level of circulating CD4(+) T regulatory cells had a strong association with outcome. Pre-IP-10 serum levels approached significance for predicting outcome.
CONCLUSIONS: The clinical and immunologic responses observed in this trial suggest an interaction between DC vaccination and cytokine therapy. Our data support the hypothesis that modulation of inflammatory, regulatory, and angiogenic pathways are necessary to optimize therapeutic benefit in renal cell carcinoma patients. Further exploration of this approach is warranted. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19622576 |
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