Dendritic cell-based immunotherapy in mesothelioma

Our plain-English summary of Dendritic cell-based immunotherapy in mesothelioma, by R. Cornelissen, L.A. Lievense, M.E. Heuvers, et al (Immunotherapy, 2012).

The study

• Authors: R. Cornelissen, L.A. Lievense, M.E. Heuvers, A.P. Maat, R.W. Hendriks, H.C. Hoogsteden, J.P. Hegmans, J.G. Aerts
• Journal: Immunotherapy
• Published: 2012;4(10):1011-22
• Type of article: Review
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Mesothelioma is a rare thoracic malignancy with a dismal prognosis. Current treatment options are scarce and clinical outcomes are rather disappointing. Due to the immunogenic nature of mesothelioma, several studies have investigated immunotherapeutic strategies to improve the prognosis of patients with mesothelioma. In the last decade, progress in knowledge of the modulation of the immune system to attack the tumor has been remarkable, but the optimal strategy for immunotherapy has yet to be unraveled. Because of their potent antigen-presenting capacity, dendritic cells are acknowledged as a promising agent in immunotherapeutic approaches in a number of malignancies. This review gives an update and provides a future perspective in which immunotherapy may improve the outcome of mesothelioma therapy.

In plain English

This article was a review, not a new study. The authors, from Erasmus MC in Rotterdam, the Netherlands, summarized published research on immune-based treatment for mesothelioma, focusing on dendritic cells. These are immune cells that present tumor material to other immune cells. The review described other studies. One was the authors' own earlier mouse study, in which dendritic cell injections given before tumor implantation prevented mesothelioma from developing, while injections on the day of implantation promoted tumor growth. Another research group's vaccine trial enrolled 22 patients, and 32% developed at least one type of immune response. The review covered the authors' earlier clinical trial in ten patients. No grade 3 or 4 toxicities were reported. Nine patients showed increased levels of a marker of cell-killing immune cells, and four of the six patients tested showed killing activity against their own tumor cells. The authors said that, as a proof-of-principle study, that trial allowed no conclusions about whether progression-free or overall survival improved. The authors concluded that dendritic cell-based therapy was, in their view, one of the most exciting options.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of published preclinical and clinical research on immunotherapy, especially dendritic cell-based immunotherapy, in mesothelioma
• Who was studied: No study population of its own. The authors reviewed published laboratory, animal and clinical studies of immunotherapy in mesothelioma.
• Exposure: Not an exposure study; the subject is treatment. As background, the review described how inhaled asbestos fibers are thought to damage cells.
• Main results:
  • Reviewed finding from the authors' earlier mouse study: dendritic cell immunotherapy given before tumor inoculation prevented mesothelioma development in mice.
  • Reviewed finding from the same mouse study: injecting the dendritic cells on the day of tumor implantation promoted tumor growth.
  • Reviewed finding from another group's 2006 trial of a vaccine made from the patient's own tumor material plus GM-CSF: 22 patients were enrolled.
  • In that 2006 trial, 32% of the patients developed at least one type of immune response against mesothelioma.
  • Reviewed finding from the authors' earlier clinical trial in ten mesothelioma patients: no grade 3 or 4 toxicities were reported.
  • In the same trial, nine patients showed a significantly increased percentage of granzyme B-positive CD8+ T cells (a marker of cell-killing immune cells) after vaccination.
  • In the same trial, killing activity was tested in six of the ten patients, and four showed clear cytotoxicity against their own tumor cells.
• The authors' conclusion: The authors concluded that giving patients dendritic cells loaded with their own tumor cell material was safe and feasible. In their view, dendritic cell-based therapy is one of the most exciting options among the immunotherapy strategies being tested in mesothelioma.
• Limitations the authors state:
  • The authors' clinical trial was a proof-of-principle study, so no conclusions could be drawn about whether progression-free or overall survival improved.
  • Trials that use the patient's own tumor material exclude patients from whom not enough tissue can be collected.
  • There is no agreement on the best way to generate dendritic cells for immunotherapy.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Immunotherapy, Mesothelioma, Prognosis.

Related studies

• Adjuvant dendritic cell based immunotherapy (DCBI) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal mesothelioma, a phase II single centre open-label clinical trial: rationale and design of the MESOPEC trial — N.L. de Boer, J.P. van Kooten, et al. (2019)
• New roads open up for implementing immunotherapy in mesothelioma — R. Cornelissen, M.E. Heuvers, et al. (2012)
• Depletion of Tumor-Associated Macrophages with a CSF-1R Kinase Inhibitor Enhances Antitumor Immunity and Survival Induced by DC Immunotherapy — F. Dammeijer, L.A. Lievense, et al. (2017)
• Tumor-infiltrating dendritic cells exhibit defective cross-presentation of tumor antigens, but is reversed by chemotherapy — A.M. McDonnell, W.J. Lesterhuis, et al. (2015)
• Anti-cancer therapy using dendritic cells and apoptotic tumour cells: pre-clinical data in human mesothelioma and acute myeloid leukaemia — M. Grégoire, C. Ligeza-Poisson, et al. (2003)
• Dendritic Cells in Human Lung Disease: Recent Advances — J.W. Upham, Y. Xi (2017)

Browse more research in Immunotherapy, or return to medical research.