Abstract
AIM: To improve treatment of high-grade glioma (HGG) with immune therapy based on vaccination with autologous dendritic cells (DC) loaded with tumour-derived lysate (DCm-HGG-L). BACKGROUND: Immune therapy of CNS tumours is an emerging modality that potentially can enhance the current multimodal treatment approaches being used. This autologous vaccine is both tumour-specific and well tolerated, given intradermally, a technique which has been developed by van Gool et al in Leuven, Belgium. METHODS: Adult patients underwent leukaferesis after radical surgery. The DC were extracted by CD14+ enrichement with the CliniMacs platform. Blood samples for immunologic stimulation analysis (CD4, CD8) were collected prior to therapy and before each intradermal vaccination. RESULTS: Since December 2009, DCm-HGG-L has been produced at the Karolinska University Hospital for HGG patients, according to a GMP protocol required by the Medical Product Agency. Twelve patients have been treated, 6 with de novo glioblastoma, 4 with recurrent high grade glioma, one with recurrent PNET, and one with recurrent rhabdoid tumor. Age 2 and 20-50 yr, KPS 70-100. All underwent radical surgery followed by radiochemotherapy. Median PFS 2 yrs. The CD4 and CD8 blasts increased and remained at high level after the 3 rd vaccine. CONCLUSION: The immunological therapy for High Grade Glioma is safe. Further evaluation is under way to implement this strategy, especially in the adult population.
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