Bauer C, Bauernfeind F, Sterzik A, Orban M, Schnurr M, Lehr H A, Endres S, Eigler A, Dauer M
Section of Gastroenterology, Medizinische Klinik Innenstadt, University of Munich, Ziemssenstr. 1, 80336 Munich, Germany.
Gut. 2007 Sep;56(9):1275-82. doi: 10.1136/gut.2006.108621. Epub 2007 Mar 29.
Tumour-specific cytotoxic T lymphocytes (CTLs) can be activated in vivo by vaccination with dendritic cells (DCs). However, clinical responses to DC-based vaccination have only been observed in a minority of patients with solid cancer. Combination with other treatment modalities such as chemotherapy may overcome immunoresistance of cancer cells. It has been shown previously that gemcitabine sensitises human pancreatic carcinoma cells against CTL-mediated lysis. Here, a murine pancreatic carcinoma model was used to investigate whether combination with gemcitabine increases therapeutic efficacy of DC-based vaccination.
Bone marrow-derived DCs from C57BL/6 mice were loaded with UV-irradiated, syngeneic Panc02 carcinoma cells and were administered subcutaneously. For prophylactic vaccination, mice were vaccinated three times at weekly intervals prior to tumour challenge with Panc02 cells. Therapeutic vaccination was started when tumours formed a palpable nodule. Gemcitabine was administered intraperitoneally twice weekly.
Prophylactic DC-based vaccination completely prevented subcutaneous and orthotopic tumour development and induced immunological memory as well as tumour antigen-specific CTLs. In the subcutaneous tumour model, therapeutic DC-based vaccination was equally effective as gemcitabine (14% vs 17% survival at day 58 after tumour challenge; controls, 0%). Combination of the two strategies significantly increased survival of tumour-bearing mice (50% at day 58 after tumour challenge). DC-based vaccination also prevented death from pulmonary metastatisation after intravenous injection of Panc02 cells.
DC-based immunotherapy may not only be successfully combined with gemcitabine for the treatment of advanced pancreatic carcinoma, but may also be effective in preventing local recurrence or metastatisation in tumour-free patients.
肿瘤特异性细胞毒性T淋巴细胞(CTL)可通过接种树突状细胞(DC)在体内被激活。然而,基于DC的疫苗接种的临床反应仅在少数实体癌患者中观察到。与其他治疗方式如化疗联合使用可能会克服癌细胞的免疫抗性。先前已表明吉西他滨可使人类胰腺癌细胞对CTL介导的裂解敏感。在此,使用小鼠胰腺癌模型来研究与吉西他滨联合使用是否会提高基于DC的疫苗接种的治疗效果。
将来自C57BL/6小鼠的骨髓源性DC用紫外线照射的同基因Panc02癌细胞负载,并皮下给药。对于预防性疫苗接种,在接种Panc02细胞进行肿瘤攻击之前,小鼠每周接种三次,共接种三次。当肿瘤形成可触及的结节时开始进行治疗性疫苗接种。吉西他滨每周两次腹腔内给药。
基于DC的预防性疫苗接种完全阻止了皮下和原位肿瘤的发展,并诱导了免疫记忆以及肿瘤抗原特异性CTL。在皮下肿瘤模型中,基于DC的治疗性疫苗接种与吉西他滨同样有效(肿瘤攻击后第58天的生存率分别为14%和17%;对照组为0%)。两种策略联合使用显著提高了荷瘤小鼠的生存率(肿瘤攻击后第58天为50%)。基于DC的疫苗接种还可预防静脉注射Panc02细胞后因肺转移导致的死亡。
基于DC的免疫疗法不仅可以成功地与吉西他滨联合用于治疗晚期胰腺癌,而且对于预防无瘤患者的局部复发或转移可能也有效。