Department of Pulmonary Medicine, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Clin Cancer Res. 2018 Feb 15;24(4):766-776. doi: 10.1158/1078-0432.CCR-17-2522. Epub 2017 Dec 12.
Mesothelioma has been regarded as a nonimmunogenic tumor, which is also shown by the low response rates to treatments targeting the PD-1/PD-L1 axis. Previously, we demonstrated that autologous tumor lysate-pulsed dendritic cell (DC) immunotherapy increased T-cell response toward malignant mesothelioma. However, the use of autologous tumor material hampers implementation in large clinical trials, which might be overcome by using allogeneic tumor cell lines as tumor antigen source. The purpose of this study was to investigate whether allogeneic lysate-pulsed DC immunotherapy is effective in mice and safe in humans. First, in two murine mesothelioma models, mice were treated with autologous DCs pulsed with either autologous or allogeneic tumor lysate or injected with PBS (negative control). Survival and tumor-directed T-cell responses of these mice were monitored. Results were taken forward in a first-in-human clinical trial, in which 9 patients were treated with 10, 25, or 50 million DCs per vaccination. DC vaccination consisted of autologous monocyte-derived DCs pulsed with tumor lysate from five mesothelioma cell lines. In mice, allogeneic lysate-pulsed DC immunotherapy induced tumor-specific T cells and led to an increased survival, to a similar extent as DC immunotherapy with autologous tumor lysate. In the first-in-human clinical trial, no dose-limiting toxicities were established and radiographic responses were observed. Median PFS was 8.8 months [95% confidence interval (CI), 4.1-20.3] and median OS not reached (median follow-up = 22.8 months). DC immunotherapy with allogeneic tumor lysate is effective in mice and safe and feasible in humans. .
间皮瘤被认为是非免疫原性肿瘤,这也表现在针对 PD-1/PD-L1 轴的治疗反应率低。此前,我们证明了自体肿瘤裂解物脉冲树突状细胞(DC)免疫疗法增加了对恶性间皮瘤的 T 细胞反应。然而,自体肿瘤材料的使用阻碍了在大型临床试验中的实施,这可能通过使用同种异体肿瘤细胞系作为肿瘤抗原来源来克服。本研究旨在探讨同种异体裂解物脉冲 DC 免疫疗法在小鼠中的有效性和在人类中的安全性。首先,在两种小鼠间皮瘤模型中,用自体或同种异体肿瘤裂解物脉冲的自体 DC 或 PBS(阴性对照)处理小鼠。监测这些小鼠的存活和肿瘤定向 T 细胞反应。结果在首例人体临床试验中进行了前瞻性研究,其中 9 名患者接受了 10、25 或 5000 万个 DC 接种。DC 疫苗接种由来自五个间皮瘤细胞系的肿瘤裂解物脉冲的自体单核细胞衍生 DC 组成。在小鼠中,同种异体裂解物脉冲 DC 免疫疗法诱导了肿瘤特异性 T 细胞,并导致了类似程度的存活增加,与自体肿瘤裂解物脉冲的 DC 免疫疗法相当。在首例人体临床试验中,未确定剂量限制毒性,并且观察到放射学反应。中位无进展生存期为 8.8 个月[95%置信区间(CI),4.1-20.3],中位总生存期未达到(中位随访= 22.8 个月)。同种异体肿瘤裂解物的 DC 免疫疗法在小鼠中有效,在人类中安全可行。