Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Medical Imaging Technology and Molecular Imaging, Faculty of advanced technologies in medicine, Iran University of Medical Sciences, Tehran, Iran.
Expert Rev Vaccines. 2022 Apr;21(4):513-531. doi: 10.1080/14760584.2022.2027759. Epub 2022 Mar 8.
Gliomas are major challenges of neuro-oncology due to high mortality. Clinical applications of dendritic cells (DCs) have yielded promising results in the clinical trial pipelines over decades.
In this systematic review, we critically discuss the current status, future perspective, and challenges of DC therapy for gliomas . and summarize the study population, blinding, comparators, dosage, treatment regimens, efficacy, and safety issues of the clinical trials published on DC therapy for gliomas and also report the results of our meta-analysis on safety and immunological efficacy of DC therapy for gliomas.
The results of our meta-analysis indicated that the most frequent grade I/II adverse event (AE) reported in phase I or phase I/II trials was fatigue (∼16% and 24%). Moreover, in phase II trials, fatigue and cytopenia were the most common AEs (∼9% and 14%). Meanwhile, Grade III/IV AEs were rare . Moreover, our meta-analysis indicated ∼64% CD8+ T cells infiltration into tumor site after DC therapy and also ∼45% IFNγ increase.
DC therapy could serve as a potential immunotherapy for gliomas; however, limitations exist to draw certain conclusions due to diversity of the criteria applied to assess clinical response and limited data on patients' survival.
由于高死亡率,神经肿瘤学中的胶质瘤是重大挑战。几十年来,树突状细胞(DC)的临床应用在临床试验中取得了有希望的结果。
在这项系统评价中,我们批判性地讨论了 DC 疗法治疗脑胶质瘤的现状、未来展望和挑战,并总结了已发表的脑胶质瘤 DC 疗法临床试验的研究人群、盲法、对照、剂量、治疗方案、疗效和安全性问题,并报告了我们对脑胶质瘤 DC 疗法安全性和免疫疗效的荟萃分析结果。
我们的荟萃分析结果表明,I 期或 I/II 期试验中最常报告的 1/2 级不良事件(AE)是疲劳(约 16%和 24%)。此外,在 II 期试验中,疲劳和血细胞减少症是最常见的 AE(约 9%和 14%)。同时,3/4 级 AE 罕见。此外,我们的荟萃分析表明,在接受 DC 治疗后,约有 64%的 CD8+T 细胞浸润到肿瘤部位,并且 IFNγ增加了约 45%。
DC 疗法可能成为治疗脑胶质瘤的一种潜在免疫疗法;然而,由于评估临床反应的标准存在差异,并且患者生存数据有限,因此存在一定的局限性,无法得出确定的结论。