Treatment of colon cancer with dendritic cells (DC) is one of the modern immunotherapy types. This is an opportunity to completely get rid of cancer or control the disease for a long time at an advanced stage. In Germany, doctors manufacture individual vaccines, taking into account the genetic peculiarities of the tumor in each patient, and carry out complex treatments. In German clinics, vaccination is combined with surgical tumor removal, minimally invasive destruction of metastases, and sparing methods of radiation therapy and chemotherapy. Due to these, German oncologists achieve remission in more than 90% of patients with stage 1-3 cancer and 60% of patients with stage 4.
- Is dendritic cell vaccination indicated to you?
- How dendritic cell vaccines work
- How the vaccination is carried out
- How to make an appointment for vaccination in a German clinic
Is dendritic cell vaccination indicated to you?
If you are diagnosed not in Germany, your oncologist may not offer you dendritic cell colon cancer treatment. Unfortunately, not all hospitals have certified laboratories and the technical ability to produce vaccines, and not all doctors have the relevant experience. In developed countries, dendritic cell immunotherapy is performed in virtually all people with bowel cancer.
The best time for a vaccination with DC would be after the surgical removal of the primary intestinal tumor and if they were detected by MRI, large metastases in the abdominal cavity. Such an operation is called cytoreductive; its task is to remove the maximum quantity of malignant cells surgically. German surgeons strive to achieve complete cytoreduction without leaving any malignant foci in the body. Vaccination with dendritic cells in the postoperative period destroys micrometastases that are invisible to the eye and provides a complete cure for cancer.
More than 20% of patients undergo colon cancer therapy without surgery because they already have multiple liver metastases at the time of diagnosis. In such a situation, the success of DC therapy for colon cancer is ensured by the high immunogenicity of an unremoved tumor. On the surface of colorectal tumors, there are many unique molecules (tumor-associated antigens) that are absent in healthy tissues. This is a carcinoembryonic antigen (CEA), Wilms' tumor gene 1 (WT1), mucin 1 (MUC1), and p53 protein. Due to the recognition of tumor-associated antigens, the vaccine inhibits primary tumor progression, prevents the development of new metastases, and slows down the growth of existing ones.
You can also get a colon cancer vaccine if you have been diagnosed with a recurrence of the disease after successful completion of the initial treatment: radiation therapy, surgery, and postoperative chemotherapy. The purpose of vaccination, in this case, is to control cancer better, prolong life, and alleviate the symptoms of oncology. It is effective even after the failure of the standard relapse treatment protocol.
How dendritic cell vaccines work
Dendritic cells do not destroy malignant neoplasms directly; their anticancer effect is realized through several mechanisms:
- The main mechanism is the activation and "training" of anti-cancer immunity, from which the intestinal tumor has learned to hide successfully. After vaccination, the level of cytotoxic T-lymphocytes (immune cells that directly destroy malignant cells) in the blood increases. At the same time, new T-lymphocytes are trained to recognize the specific tumor since doctors use fragments of a patient's tumor to manufacture a vaccine.
- In recent clinical trials, scientists have identified another mechanism of the colon cancer vaccine action: it destroys tumor blood vessels, depriving them of nutrients and oxygen.
German oncologists often combine the administration of colon cancer vaccine with the course of chemotherapy. Under the influence of chemotherapy drugs, tumor cells stop multiplying, but at the same time, they more actively synthesize unique molecules that allow the immune system to detect them.
«In developed countries, the combination of a standard therapeutic protocol with dendritic cell vaccination is the basis for successful treatment of metastatic colon cancer.»
Also, the combination of vaccination, other types of immunotherapy (e.g., treatment with immune checkpoint inhibitors), and chemotherapy disrupt the tumor microenvironment. The tumor microenvironment includes changes in healthy tissues that facilitate the growth of malignant cells and metastasizing. In particular, this is connected with the dysfunction of dendritic cells. Due to the presence of an immunosuppressive microenvironment, the tumor successfully hides from immune attacks. The introduction of young dendritic cells disrupts the microenvironment and masking of the tumor.
How the vaccination is carried out
To manufacture a vaccine, oncologists need two individual components. These are fragments of the patient's tumor and a special type of his leukocytes (monocytes). The other substances that are required for the technological process can be synthesized in the laboratory: a nutrient medium for monocytes to multiply, interleukins that enhance the immunogenic properties of young dendritic cells, etc.
The removed during the operation tumor undergoes fragmentation and lysis. If there was no surgery, or if the person is undergoing treatment for cancer recurrence, then tumor-specific peptides or specific RNA / DNA can serve as the tumor material. They are synthesized in the laboratory, taking into account information about the most common mutations and antigens of colorectal tumors.
While the specialists process the components of the tumor, the patient undergoes leukapheresis. This is a procedure during which doctors extract young monocytes from the blood. The blood plasma and other elements are returned to the patient, making the procedure easily tolerated and side effect free. Within 3-5 days, monocytes mature into dendritic cells, multiply on a nutrient medium, and "get acquainted" with tumor fragments. The prepared vaccine contains several million specialized dendritic cells, ready to start fighting cancer immediately.
The course of treatment consists of 3-5 injections with an interval of 2-3 weeks, while the first injection is made 2 weeks after surgery. This should be taken into account when planning treatment: many people undergo both surgery and vaccination in the same German hospital. The drug is administered subcutaneously, initially – in the inguinal region and after the healing of the postoperative suture, if any, – in the navel.
It is unnecessary to undergo leukapheresis again before repeated injections: doctors cryopreserve dendritic cells obtained during the first procedure. Thanks to special storage conditions, they fully retain their medicinal potential.
How to make an appointment for vaccination in a German clinic
You can come to Germany only for vaccination or plan a whole treatment here: preoperative radiation therapy, surgical removal of the tumor, postoperative vaccination, and chemotherapy. In the second case, doctors will give you a more personalized vaccine because it will be created using the tumor removed during surgery.
On the Booking Health website, you will find a list of German oncology centers that specialize in the treatment of colon cancer. You will also find here the nearest possible dates of appointment and the cost of different types of treatment. Thanks to Booking Health specialists, you will:
- Choose the oncological center with the highest success rates and specialization in the administration of dendritic cells in the treatment of colon cancer
- Have a distant consultation with the future attending physician
- Learn more about modern colon cancer treatments, their benefits, and peculiarities
- See the preliminary medical program
- Find the best accommodation and plane tickets
- Travel to the clinic at a convenient date
- Get medical services at the same prices as German residents, have no taxes for international patients (save up to 50%)
- Visit the clinic accompanied by an interpreter
- Get help with buying and shipping medicines to continue your treatment at home
- Keep in touch with the German doctor after returning home
Booking Health doctors will additionally control all stages of the medical program; financial specialists will check the invoices from the clinic and ensure the return of unspent deposits, and your personal medical coordinator will be in constant contact with you via messengers.
Choose treatment abroad and you will for sure get the best results!
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!