3069 Background: Vaccine therapy using dendritic cells can induce antitumor immunity. We report about the final results of a phase II-study using autologous, tumor-lysate pulsed dendritic cells (DC) for the treatment of patients with advanced pancreatic carcinoma. As all patients received concomitant chemotherapy, we investigated systematically the interplay between DC therapy and gemcitabine chemotherapy in a murine pancreatic carcinoma model, correlating the results of ex vivo immuno monitoring tools with clinical efficacy. Methods: Pancreatic carcinoma patients receiving abdominal surgery were recruited to the study. DC therapy was started after recurrence of pancreatic carcinoma or in a primarily palliative situation. Immune response was monitored by ELISPOT and proliferation assays. A pancreatic carcinoma vaccination model was established by transfecting murine pancreatic carcinoma cell line Panc02 with an OVA vector. Mice were vaccinated with bone marrow derived DC loaded with apoptotic Panc02OVA cells, OVA protein or SIINFEKL peptide. Intracellular IFN- γ staining and streptamer staining were used to examine the induction of antigen specific T cells. For tumor induction, Panc02OVA cells were orthotopically injected into C57BL/6 mice. Results: Twelve patients received DC vaccination. Four cases of at least intermittent partial remission or stable disease were seen. These patients had developed strong immunological antitumor responses as demonstrated by DTH skin testing, T cell proliferation assays and ELISPOT assays. Data in the murine model indicate that there is a synergistic clinical efficacy of gemcitabine and DC vaccination therapy despite reduction of specific cytotoxic T cells by concomitant gemcitabine therapy. Results of an in vitro cytotox assay using SIINFEKL-specific, transgene T-cells demonstrate that gemcitabine sensitizes Panc02OVA cells towards T cell mediated lysis. Conclusions: DC vaccination therapy can be of clinical benefit in the setting of advanced pancreatic carcinoma. DC therapy led to immunological responses despite concomitant chemotherapy. Data obtained in a murine model of pancreatic cancer support the concept of a combination of vaccination and chemotherapy. No significant financial relationships to disclose.
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