Abstract
Immunotherapy of malignant gliomas with autologous dendritic cells (DCs) in addition to surgery and radiochemotherapy has been a focus of intense research during the past decade. Since both children and adults are affected by this highly aggressive brain tumor, 10–15% of the several hundred vaccinated patients represent children, making pediatric glioma patients the largest uniform pediatric vaccination cohort so far. In general, DC vaccination in malignant gliomas has been shown to be safe and several studies with a non-vaccinated control group could clearly demonstrate a survival benefit for the vaccinated patients. Interestingly, children and adolescents below 21 years of age seem to benefit even more than adult patients. This review summarizes the findings of the 25 clinical trials published so far and gives a perspective how DC vaccination could be implemented as part of multimodal therapeutic strategies in the near future.
Highlights
Since the earliest descriptions of dendritic cells (DCs) in skin [1] and later in lymph nodes [2], their pivotal role in the regulation of immune responses has been recognized
It was primarily in histopathological analyses of easy accessible skin tumors that indicated a close interaction of skin DCs and T helper cells [3]. These data led to groundbreaking murine studies showing that DCs pulsed with tumor-extracts can significantly delay cancer growth [4], result in humoral and cellular immune responses [5], and confer in vivo resistance to tumor challenge [6]. These findings have been translated into clinical studies, one of the first clinical trials in patients with follicular B-cell lymphoma reported no humoral responses but increased cellular proliferation in 4/4 treated patients and clinical responses of various degree in 3/4 [7]
CONCLUDING REMARKS Available data on DC vaccination in patients with malignant glioma allow the conclusion that this therapy is safe and feasible
Summary
Since the earliest descriptions of dendritic cells (DCs) in skin [1] and later in lymph nodes [2], their pivotal role in the regulation of immune responses has been recognized It was primarily in histopathological analyses of easy accessible skin tumors that indicated a close interaction of skin DCs and T helper cells [3]. These data led to groundbreaking murine studies showing that DCs pulsed with tumor-extracts can significantly delay cancer growth [4], result in humoral and cellular immune responses [5], and confer in vivo resistance to tumor challenge [6]. This seems daunting at a first glance, many important lessons have been learnt from these trials
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