Unit of Molecular Haematology and Cancer Biology, University College London Institute of Child Health, London, UK.
Clin Transl Oncol. 2012 Apr;14(4):271-9. doi: 10.1007/s12094-012-0795-1.
Immunotherapy using autologous dendritic cell (DC) vaccination has not been systematically evaluated in osteosarcoma. We therefore conducted a phase I trial to assess feasibility, safety and tumour-specific immune responses in patients with relapsed disease.
Of 13 recruited patients with relapsed osteosarcoma, 12 received 3 weekly vaccines of autologous DCs matured with autologous tumour lysate and keyhole limpet haemocyanin (KLH), to a maximum of 6 vaccinations. An additional 3 paediatric patients afflicted with other tumour types and with relapsed disease received vaccines generated with identical methodology. Immune responses were assessed using an ELISpot assay for the detection of interferon gamma, whilst interleukin-2 and granzyme B were additionally assessed in cases where interferon-γ responses were induced.
In total 61 vaccines, of homogeneous maturation phenotype and viability, were administered with no significant toxicity. Only in 2 out of 12 treated osteosarcoma cases was there an induction of specific T-cell immune response to the tumour, whilst a strong but non-specific immune response was induced in 1 further osteosarcoma patient. Immune response against KLH was induced in only 3 out of 12 osteosarcoma patients. In contrast, three additional non-osteosarcoma patients showed significant T-cell responses to vaccine.
We have shown the strategy of DC vaccination in relapsed osteosarcoma is safe and feasible. However, significant anti-tumour responses were induced in only 2 out of 12 vaccinated patients with no evidence of clinical benefit. Comparison of results with identically treated control patients suggests that osteosarcoma patients might be relatively insensitive to DC-based vaccine treatments.
自体树突状细胞(DC)疫苗免疫疗法尚未在骨肉瘤中进行系统评估。因此,我们进行了一项 I 期试验,以评估复发疾病患者的可行性、安全性和肿瘤特异性免疫反应。
在 13 名招募的骨肉瘤复发患者中,12 名患者接受了 3 次每周的自体 DC 疫苗接种,这些 DC 是用自体肿瘤裂解物和钥孔血蓝蛋白(KLH)成熟的,最多可接种 6 次疫苗。另外 3 名患有其他肿瘤类型和复发疾病的儿科患者接受了用相同方法生成的疫苗。使用酶联免疫斑点测定法(ELISpot)检测干扰素γ来评估免疫反应,而在诱导干扰素-γ反应的情况下,还评估了白细胞介素-2 和颗粒酶 B。
共给予了 61 种具有均匀成熟表型和活力的疫苗,没有明显的毒性。在 12 名接受治疗的骨肉瘤患者中,只有 2 例诱导了针对肿瘤的特异性 T 细胞免疫反应,而在另外 1 例骨肉瘤患者中诱导了强烈但非特异性免疫反应。在 12 名骨肉瘤患者中,只有 3 名诱导了针对 KLH 的免疫反应。相比之下,另外 3 名非骨肉瘤患者对疫苗表现出明显的 T 细胞反应。
我们已经证明了复发骨肉瘤中 DC 疫苗接种的策略是安全可行的。然而,在 12 名接种患者中,只有 2 名诱导了显著的抗肿瘤反应,没有临床获益的证据。与同样接受治疗的对照患者的结果比较表明,骨肉瘤患者可能对基于 DC 的疫苗治疗相对不敏感。