Skip to content

Advertisement

  • Poster presentation
  • Open Access

Dendritic cell vaccine treatment for indolent B cell non-hodgkin lymphoma: clinical trial in progress

  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Journal for ImmunoTherapy of Cancer20142 (Suppl 3) :P76

https://doi.org/10.1186/2051-1426-2-S3-P76

  • Published:

Keywords

  • Tumor Lysate
  • Major Adverse Event
  • Mature Dendritic Cell
  • Dendritic Cell Vaccine
  • Vaccine Approach

Introduction

We present the preliminary results of our clinical trial testing 2 vaccine strategies in patients with indolent B cell non-Hodgkin lymphoma (NHL; NCT01239875, http://clinicaltrials.gov). The primary objective is to determine the safety and feasibility of the vaccine approaches and secondary objectives are to describe clinical responses and identify corresponding immune changes.

Methods

Autologous mature dendritic cells (mDC) were manufactured from leukapheresed cells of NHL patients. For patients with tumor lymph nodes deemed amenable to cryoablation by interventional radiologist (arm A), they received cryoablation of a node and injection of mDC into the cryoablated node followed by another 1 to 7 intratumoral mDC injections. Remaining patients had a tumor excised to generate tumor lysate ex vivo. mDC were pulsed with tumor lysate during DC maturation (arm B; DC-TL). The DC-TL vaccines were injected intradermally for 4 to 8 doses. Patients are monitored for one year after vaccines for adverse events and systemic tumor response. Correlative studies include cellular immune phenotype of peripheral blood and T cell intracellular cytokine productions. Planned accrual is 10 patients per arm (total = 20).

Results

To date, 10 patients have accrued to arm A and 5 patients to arm B. All patients tolerated vaccine treatments without major adverse events. Of the 10 evaluable patients, there were 1 CR (arm B: 1 / 4; total: 1/10) and 4 PR (arm A: 3/6; arm B: 1 / 4; total: 5/10) for an ORR of 50% for both arms (Table 1). Responses have been durable for at least 1 year. Correlative studies suggest that immune changes can be used as prognostic biomarkers to predict response. Upon stimulation, responders' T cells had increased IFN-γ and or IL-17a and lower IL-4 production than non-responder T cells. Preliminary analysis of >80 immune phenotypes using flow cytometry and hierarchical clustering suggest that, after vaccination, many components within the immune system of responders change in a different manner from the non-responders.
Table 1

Patient responses

Arm

ID

Age/

Gender

Histology

Stage

FLIPI/IPI

# of prior Tx

DC doses

Best response

Time to next treatment or event (months)

A

LSA1

57M

Follicular

IVA

2

1

2

SD

25

A

LSA2

56F

Follicular

IIIB

4

2

2

SD

14

A

LSA3

69M

Follicular

IVA

3

4

2

PR

22

A

LSA4

60F

Follicular

IVA

3

3

2

PR

20

A

LSA5

64F

Follicular

IVA

5

8

8

PR

Not reached (12 mo at the time of abstract.)

A

LSA6

81M

Follicular

IVA

4

1

8

SD

Not reached (9 mo at the time of abstract.)

B

LSB1

60M

Follicular

IIIA

3

1

4

SD

6.5

B

LSB2

62F

Marginal zone

IVAE

4

6

4

SD

7.6

B

LSB3

65F

Follicular

IVA

3

2

8

CR

Not reached (13 mo at the time of abstract.)

B

LSB4

31F

Follicular

IIIA

2

0

8

PR

Not reached (12 mo at the time of abstract.)

Conclusions

Both cryoablation and intratumoral mDC vaccination are feasible and safe in NHL. Treatment responses may correlate with immune system changes. Biosystems analysis method can be used to develop novel assays as predictive biomarkers of treatment response.

Authors’ Affiliations

(1)
Mayo Clinic, Rochester, MN, USA

Copyright

Advertisement