Abstract
Ovarian cancer (OC) is one of the most lethal malignant gynecologic tumors, characterized by an uncertain presentation and poor outcomes. With or without neoadjuvant chemotherapy, surgery followed by platinum-based chemotherapy and maintenance therapy are the basis for the treatment of ovarian cancer patients, but the outcome is still highly restricted by their advanced stage when diagnosed and high recurrence rate after chemotherapy. To enhance the anti-tumor effect and postpone recurrence, anti-VEGF agents and PARP inhibitors are suggested as maintenance therapy, but the population that can benefit from these treatments is small. Based on the interactions of immune cells in the tumor microenvironment, immunotherapies are being explored for ovarian cancer treatment. Disappointingly, the immune checkpoint inhibitors show relatively low responses in ovarian cancer. As shown in several studies that have uncovered a relationship between DC infiltration and outcome in ovarian cancer patients, dendritic cell (DC)-based treatments might have a potential effect on ovarian cancer. In this review, we summarize the functions of dendritic cells (DCs) in the tumor microenvironment, as well as the responses and drawbacks of existing clinical studies to draw a comprehensive picture of DC vaccine treatment in ovarian cancer and to discuss the promising future of immune biomarkers.
Highlights
Ovarian cancer is the most lethal gynecological cancer, with an overall 5-year-survival rate of 48% (US, reported in 2020)
The common routine of dendritic cell (DC) vaccine manufacturing includes several elements: [1] obtaining human DC developmental potential cells through apheresis; [2] stimulating autologous immature DCs into a mature state in vitro, in which process the DCs are usually activated by a cocktail of various cytokines, Toll-like receptors agonists and other activators; and [3] loading the immature DCs with tumor-associated antigens, namely, DCs being cocultured with antigens in the form of peptides, proteins, tumor cell lysates or tumor cells
In a phase I trial of DC vaccine in the maintenance therapy for ovarian cancer [17], Tanyi et al reported that more adverse events emerged in the patients who received a combination of DC vaccine, bevacizumab, and cyclophosphamide
Summary
Xi Zhang 1‡, Tianhui He 1†‡, Yuan Li 1, Ling Chen 2, Hongyu Liu 3, Yu Wu 1 and Hongyan Guo 1*. To enhance the anti-tumor effect and postpone recurrence, antiVEGF agents and PARP inhibitors are suggested as maintenance therapy, but the population that can benefit from these treatments is small. Based on the interactions of immune cells in the tumor microenvironment, immunotherapies are being explored for ovarian cancer treatment. As shown in several studies that have uncovered a relationship between DC infiltration and outcome in ovarian cancer patients, dendritic cell (DC)-based treatments might have a potential effect on ovarian cancer. We summarize the functions of dendritic cells (DCs) in the tumor microenvironment, as well as the responses and drawbacks of existing clinical studies to draw a comprehensive picture of DC vaccine treatment in ovarian cancer and to discuss the promising future of immune biomarkers
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