Author of

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  P3.11 - Poster Session 3 - NSCLC Novel Therapies (ID 211)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12666

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    P3.11-018 - Clinical Response of Lung Cancer Patients to Autologous Dendritic Cell Vaccination: A Compilation of Cases from the Lung Center of the Philippines (ID 1709)

    09:30 - 09:30  |  Author(s): G.E. Ladrera
    • Abstract

    Background
    A number of lung cancer patients at different disease stages has availed of the autologous dendritic cell vaccination therapy since it was instituted as an adjunct therapy in 2009 at the Molecular Diagnostics and Cellular Therapeutics Laboratory of the Lung Center of the Philippines.

    Methods
    Following a protocol approved by the Institutional Ethics Review Board of the hospital and after a Safety Evaluation Trial involving 3 patients demonstrating patient tolerance to autologous DC with no adverse reaction, at least 19 lung cancer patients were treated. The protocol involves 1) consultation 2) signing of informed consent 3) extraction of blood for circulating tumor cells and blood tests 4) hematology clearance 5) growth factor administration 6) admission and central line insertion 7) leukapheresis (stem cell collection) 8) dendritic cell culture and maturation 9) vaccination and 10) IFN-gamma analysis. The compiled clinical responses include survival rate at different time points, PET/CT scan results, circulating tumor cell (CTC) gene expression profile, and plasma interferon gamma levels.

    Results
    Comparative survival rate at 9 months post-vaccination vs. average survival were the following: stage II, 100% vs. 75%; stage III, 85.71% vs. 60% and stage IV, 28.57% vs. 23%. The PET/CT Scan results showed a general pattern of remission and/or regression of the tumor, or stabilization of the disease process in 58% of the patients. The circulating tumor cell (CTC) gene expression profile using a panel of 14 Tumor Associated Genes (TAGs) showed at least two were positive in the patients' blood sample which could have upregulated expression. ERBB2 appeared as the most positive gene marker in all the samples (i.e. Rank 1). Livin showed the most elevated expression followed by ACTN4. KRT19 showed moderate expression while EGFR showed all downregulated expression. Post-vaccination monitoring showed a decline or complete abrogation of expression of the TAGs. The interferon gamma profile showed that majority (90%) of the patients had IFN gamma values above 10 pg/ml. A general trend of increasing IFN gamma is observed in the first 3 vaccinations, followed by a decline and subsequent increase in the fifth and sixth vaccination correlating with the introduction of new sets of antigens coming from the result of the follow-up CTC gene expression analysis. General observation indicated higher IFN gamma values correlate with better patient survival.

    Conclusion
    Thus, the clinical data of the patients who have undergone the DC vaccination therapy have indicated the positive effects of autologous DC as an alternative adjunct therapy for lung cancer specifically for stages II and III. This data also points to the importance of early diagnosis of lung cancer as well as the development of more aggressive immunotherapeutic interventions for stage IV cases (e.g. tumor-specific cytotoxic T-cells) which are the current directions of the Center.