Pancreatic cancer is an aggressive tumor of the digestive system. One of the reasons for the low effectiveness of treatment for pancreatic tumors is the weak anti-tumor immune response. But it can be boosted with a dendritic cell-based cancer immunotherapy, i.e. anti-tumor vaccine. Let's talk about the administration of dendritic cells in pancreatic cancer, what problems they solve and the results of using dendritic cell vaccines in preclinical and clinical trials.
- How autologous dendritic cells work in pancreatic cancer
- The effects of autologous dendritic cells
- How dendritic cell therapy for pancreatic cancer is performed
- Results of clinical trials of dendritic cell therapies
- Where to treat pancreatic cancer with a dendritic cell vaccin
How autologous dendritic cells work in pancreatic cancer
Pancreatic cancer is difficult to treat because most treatments that work well for other types of cancer are ineffective. This also includes immune therapies that have failed. The pancreatic tumor does not respond to cytokines, immune checkpoint inhibitors, and adoptive cell therapy. What is the cause?
Recent research suggests that the cause is a deficiency of dendritic cell activation. Dendritic cells (DCs) are immune cells that recognize antigens (targets for attack) and show them to T-cells. As a result, the T-cells know their enemy and begin to attack the antigens, in this case these are the antigens of pancreatic malignant neoplasms.
In experiments on mice, the researchers found that the microenvironment of pancreatic tumors contains very few dendritic cells. In contrast, the microenvironment of lung cancer, which responds well to immunotherapy, contains 80 times more dendritic cells. In addition, dendritic cells are less functional in pancreatic cancer. Finally, they are located at a greater distance from the pancreatic neoplasm than in lung cancer.
It was thought that targeting dendritic cells would make the human immune system "come alive" and attack the tumor. This was eventually confirmed. Studies have shown that the introduction of dendritic cells helps to stabilize the disease and reduces the risk of metastasizing. There is no doubt that this discovery will soon lead to a breakthrough in the treatment of pancreatic cancer, a disease that is still virtually incurable: over time, the cancer relapses even after the complete tumor removal. It is possible that dendritic cells will help to prevent recurrence and thus enable a complete cure of the cancer at an operable stage.
The effects of autologous dendritic cells
In studies on laboratory animals as well as in clinical trials, dendritic cells have been found to demonstrate these effects in different pancreatic cancer stages:
- Enhance the natural anti-tumor immune response – that is, dendritic cells are themselves an immune therapy for cancer
- Enhance the efficacy of other immunotherapeutic agents
- Increase tumor susceptibility to radiation therapy
Radiation therapy for pancreatic cancer usually does not demonstrate high efficacy. Apparently, this is due to the lack of stimulation of antitumor immunity during the mass decay of cancer cells and the release of antigens into the systemic bloodstream, as it happens with other tumors. Dendritic cells appear to successfully address this problem. With their help, radiation therapy regains its immunostimulatory properties and therefore becomes more effective.
How dendritic cell therapy for pancreatic cancer is performed
Autologous (own) dendritic cells are used to treat pancreatic ductal adenocarcinoma. For DSc activation doctors use antigens of a patient’s own tumor or lysate of allogeneic (donor) dendritic cells, which contains antigens common to different tumors.
Autologous cells are more commonly used. Monocytes (a type of leukocytes) for dendritic cell production are harvested from the patient's blood by leukapheresis and are treated with tumor antigens. The result is a personalized vaccine that is administered intravenously. Several tens of millions of dendritic cells are usually used per injection. Several injections are required in total.
It is not possible to describe the exact regimen because the treatment is not yet standardized. Different clinics use different approaches and it is still not known at what time, dose, course and intervals dendritic cell therapy for pancreatic cancer should be administered to achieve the best therapeutic results.
Results of clinical trials of dendritic cell therapies
Clinical trials on the efficacy of dendritic cell therapy have been conducted at many medical centers over the past 10 years. For example, the study "Evaluation of the efficacy of dendritic cell therapy (LANEX-DC®) in the treatment of pancreatic cancer" contains the results of a single-center analysis by Frank Gansauge and Bertram Poh (07.2022). The results state that the therapy was well tolerated and no serious side effects were observed. Median relapse-free survival and median survival time were 16.9 months and 29.4 months, respectively. The therapy increased five-year survival by 14.3% and 17.9%, respectively. The conclusion is that adjuvant treatment with dendritic cells (LANEX-DC®) is highly effective and increases both median relapse-free survival and median survival.
The REACtiVe (Rotterdam PancrEAtic Cancer Vaccination) trial used dendritic cells in patients with resectable pancreatic cancer. They were given after removal of the pancreatic tumor, in addition to standard therapy. Patient enrollment was completed in 2020, so there is no long-term survival data. All that is known is that over a follow-up period of 15 to 32 months (average 25 months, more than two years), 70% of patients showed no signs of recurrence.
Another study, published in 2017 in the journal Clinical Cancer Research, was conducted on patients with stage 4 pancreatic cancer. Researchers used dendritic cells in addition to standard chemotherapy. There were also groups of patients who received only dendritic cells, only chemotherapy, or only symptomatic therapy. It turned out that overall and relapse-free survival rates were much better in the dendritic cell plus chemotherapy group. Moreover, double administration of dendritic cells was more effective compared to a single treatment.
Where to treat pancreatic cancer with a dendritic cell vaccine
It will be years before dendritic cell therapy for pancreatic cancer becomes part of standard therapy. Many studies are needed to evaluate the efficacy as well as to determine the best way to administer dendritic cell vaccines.
But if you want to take advantage of this method of cancer treatment now, you can undergo treatment in Germany. Booking Health specialists will find you a clinic where this method is applied: it is still experimental, but it has already proven itself in clinical trials.
On the Booking Health website you can find the cost of treatment abroad, compare prices and make an appointment in a specialized clinic for convenient dates. Booking Health specialists will assist in organizing your trip and provide support during the whole period of pancreatic cancer treatment in Germany.
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!