Lung Cancer and Dendritic Cell Therapy
Dendritic cell-based immunotherapy has been established to be safe and is known to induce antitumor immunity, even in patients with advanced cancers. Dendritic cells, which are cellular mediators in cancers, have shown promising results especially as far as improved survival is concerned.
Dendrite cells are readily obtained in large numbers from peripheral blood or CD34+ bone marrow progenitors expanded in vitro in medium containing various combinations of cytokines, including GM-CSF, interleukin 4 (IL-4), c- kit ligand and tumor necrosis factor α (TNF-α).
The efficacy of dendritic cell-based vaccine therapy has been observed in clinical trials in patients with various cancers and is being considered as an emerging paradigm of combination therapy with other cancer therapies. Treatment with dendritic cell vaccination is an approved therapeutic option in advanced prostate cancer.
Lung cancer is the most common cancer worldwide with a high cancer-related mortality rate. Non-small cell lung cancers (NSCLC) form the majority (about 80%) of lung cancers, which tend to progress very quickly and are highly malignant. The usual treatments include surgery, radiation, and chemotherapy.
Usually NSCLC is diagnosed at a later stage (IIIb or IV), and hence, surgical option is limited leading to poor prognosis despite treatment with radiotherapy or systemic chemotherapy. In addition, toxicity is common. Despite the developments in chemotherapy regimens and radiotherapy, the 5 year survival rate has improved only by 3% (from13% to 16.2%). This is because there is no efficient screening method for the early diagnosis of NSCLC and new therapeutic modalities are necessary to improve clinical outcomes. Therefore, multidisciplinary approaches with novel treatments for advanced NSCLC are the focus of cancer researchers.
Immunotherapy has been established to be particularly effective in advanced-stage disease. Immune cells, including cytokine-induced killer cells and dendritic cells, produce an effective immune response against cancer cells, killing cancer cells and residual cells.
A combination of standard cancer treatments along with immunotherapy can considerably reduce the cancer mortality risk. Dendritic cell vaccine has important clinical implications since the method could boost the cancer-killing power of anti-PD-1 immunotherapies that are currently being evaluated in NSCLC and other advanced cancers, which are very difficult to treat successfully.
Clinical studies have evaluated the feasibility, safety, tolerability and immunologic responses in use in mature, antigen-pulsed autologous dendritic cell vaccine in a group of NSCLC patients and found encouraging results. Longer survival time was reported, as well as a boost in the immunological response was observed with a second vaccine dose, providing evidence for the need for multiple vaccine doses in solid tumors such as NSCLC.
Recently, dendritic cell vaccine and cytokine-induced killer cell therapy was found to be beneficial in advanced NSCLC patients. There were no severe adverse effects resulting from this therapy, and in addition, another study endorsed that cancer-associated fatigue is also alleviated with this therapy. Furthermore, an immune response against NSCLC was produced, and consequently the overall survival time was lengthened and the quality of life was much improved in the patients concluding firm benefits of dendritic cell-based vaccines in patients with advanced NSCLC.