Delayed Effect of Dendritic Cells Vaccination on Survival in Glioblastoma: A Systematic Review and Meta-Analysis

Overview

Journal Curr Oncol

Publisher MDPI

Specialty Oncology

Date 2022 Feb 24

PMID 35200574

Authors

Salvatore Cozzi

Masoumeh Najafi

Marzieh Gomar

Patrizia Ciammella

Cinzia Iotti

Corrado Iaccarino

Massimo Dominici

Giacomo Pavesi

Chiara Chiavelli

Ali Kazemian

Amin Jahanbakhshi

Affiliations

Soon will be listed here.

Abstract

Background: Dendritic cell vaccination (DCV) strategies, thanks to a complex immune response, may flare tumor regression and improve patients' long-term survival. This meta-analysis aims to assess the efficacy of DCV for newly diagnosed glioblastoma patients in clinical trials.

Methods: The study databases, including PubMed, Web of Knowledge, Google Scholar, Scopus, and Cochrane, were searched by two blinded investigators considering eligible studies based on the following keywords: "glioblastoma multiforme", "dendritic cell", "vaccination", "immunotherapy", "immune system", "immune response", "chemotherapy", "recurrence", and "temozolomide". Among the 157 screened, only 15 articles were eligible for the final analysis.

Results: Regimens including DCV showed no effect on 6-month progression-free survival (PFS, HR = 1.385, 95% CI: 0.822-2.335, = 0.673) or on 6-month overall survival (OS, HR = 1.408, 95% CI: 0.882-2.248, = 0.754). In contrast, DCV led to significantly longer 1-year OS (HR = 1.936, 95% CI: 1.396-2.85, = 0.001) and longer 2-year OS (HR = 3.670, 95% CI: 2.291-5.879, = 0.001) versus control groups. Hence, introducing DCV could lead to increased 1 and 2-year survival of patients by 1.9 and 3.6 times, respectively.

Conclusion: Antitumor regimens including DCV can effectively improve mid-term survival in patients suffering glioblastoma multiforme (GBM), but its impact emerges only after one year from vaccination. These data indicate the need for more time to achieve an anti-GBM immune response and suggest additional therapeutics, such as checkpoint inhibitors, to empower an earlier DCV action in patients affected by a very poor prognosis.

Citing Articles

Autologous tumor lysate-loaded dendritic cell vaccination in glioblastoma patients: a systematic review of literature.

Shah S, Nag A, Lucke-Wold B Clin Transl Oncol. 2024; .

PMID: 39714754 DOI: 10.1007/s12094-024-03830-9.

Radiation-Associated Angiosarcoma of the Breast: The State of the Art of a Rare and Aggressive Disease.

Cozzi S, Finocchi Ghersi S, Tava F, Bardoscia L, Najafi M, Ruggieri M J Pers Med. 2024; 14(8).

PMID: 39202050 PMC: 11355165. DOI: 10.3390/jpm14080859.

Dendritic cell vaccine for glioblastoma: an updated meta-analysis and trial sequential analysis.

Wong C, Chang Y, Chen P, Huang Y, Chang Y, Chiang C J Neurooncol. 2024; 170(2):253-263.

PMID: 39167243 DOI: 10.1007/s11060-024-04798-w.

Glioblastoma Therapy: Past, Present and Future.

Obrador E, Moreno-Murciano P, Oriol-Caballo M, Lopez-Blanch R, Pineda B, Gutierrez-Arroyo J Int J Mol Sci. 2024; 25(5).

PMID: 38473776 PMC: 10931797. DOI: 10.3390/ijms25052529.

Dendritic cell vaccination for glioblastoma multiforme patients: has a new milestone been reached?.

Van Gool S, Makalowski J, Kampers L, Van de Vliet P, Sprenger T, Schirrmacher V Transl Cancer Res. 2023; 12(8):2224-2228.

PMID: 37701100 PMC: 10493805. DOI: 10.21037/tcr-23-603.

References

Batich K, Swartz A, Sampson J . Enhancing dendritic cell-based vaccination for highly aggressive glioblastoma. Expert Opin Biol Ther. 2014; 15(1):79-94. DOI: 10.1517/14712598.2015.972361. View

Yao Y, Luo F, Tang C, Chen D, Qin Z, Hua W . Molecular subgroups and B7-H4 expression levels predict responses to dendritic cell vaccines in glioblastoma: an exploratory randomized phase II clinical trial. Cancer Immunol Immunother. 2018; 67(11):1777-1788. PMC: 11028057. DOI: 10.1007/s00262-018-2232-y. View

Cao J, Zhang X, Liu J, Li D, Li J, Liu Y . Clinical efficacy of tumor antigen-pulsed DC treatment for high-grade glioma patients: evidence from a meta-analysis. PLoS One. 2014; 9(9):e107173. PMC: 4162602. DOI: 10.1371/journal.pone.0107173. View

Chang C, Huang Y, Yang D, Kikuta K, Wei K, Kubota T . A phase I/II clinical trial investigating the adverse and therapeutic effects of a postoperative autologous dendritic cell tumor vaccine in patients with malignant glioma. J Clin Neurosci. 2011; 18(8):1048-54. DOI: 10.1016/j.jocn.2010.11.034. View

Roth C, Rochlitz C, Kourilsky P . Immune response against tumors. Adv Immunol. 1994; 57:281-351. DOI: 10.1016/s0065-2776(08)60675-6. View

Pavelka Z, Zitterbart K, Noskova H, Bajciova V, Slaby O, Sterba J . Effective Immunotherapy of Glioblastoma in an Adolescent with Constitutional Mismatch Repair-Deficiency Syndrome. Klin Onkol. 2019; 32(1):70-74. DOI: 10.14735/amko201970. View

Yamanaka R, Homma J, Yajima N, Tsuchiya N, Sano M, Kobayashi T . Clinical evaluation of dendritic cell vaccination for patients with recurrent glioma: results of a clinical phase I/II trial. Clin Cancer Res. 2005; 11(11):4160-7. DOI: 10.1158/1078-0432.CCR-05-0120. View

Desai R, Suryadevara C, Batich K, Farber S, Sanchez-Perez L, Sampson J . Emerging immunotherapies for glioblastoma. Expert Opin Emerg Drugs. 2016; 21(2):133-45. PMC: 4915370. DOI: 10.1080/14728214.2016.1186643. View

Vik-Mo E, Nyakas M, Mikkelsen B, Moe M, Due-Tonnesen P, Suso E . Therapeutic vaccination against autologous cancer stem cells with mRNA-transfected dendritic cells in patients with glioblastoma. Cancer Immunol Immunother. 2013; 62(9):1499-509. PMC: 3755221. DOI: 10.1007/s00262-013-1453-3. View

10.

Beatty G, Gladney W . Immune escape mechanisms as a guide for cancer immunotherapy. Clin Cancer Res. 2014; 21(4):687-92. PMC: 4334715. DOI: 10.1158/1078-0432.CCR-14-1860. View

11.

Golinelli G, Grisendi G, Prapa M, Bestagno M, Spano C, Rossignoli F . Targeting GD2-positive glioblastoma by chimeric antigen receptor empowered mesenchymal progenitors. Cancer Gene Ther. 2018; 27(7-8):558-570. PMC: 7445885. DOI: 10.1038/s41417-018-0062-x. View

12.

Callahan M . Immune Checkpoint Therapy in Melanoma. Cancer J. 2016; 22(2):73-80. DOI: 10.1097/PPO.0000000000000183. View

13.

Li X, Wenes M, Romero P, Huang S, Fendt S, Ho P . Navigating metabolic pathways to enhance antitumour immunity and immunotherapy. Nat Rev Clin Oncol. 2019; 16(7):425-441. DOI: 10.1038/s41571-019-0203-7. View

14.

Wculek S, Cueto F, Mujal A, Melero I, Krummel M, Sancho D . Dendritic cells in cancer immunology and immunotherapy. Nat Rev Immunol. 2019; 20(1):7-24. DOI: 10.1038/s41577-019-0210-z. View

15.

Yu J, Liu G, Ying H, Yong W, Black K, Wheeler C . Vaccination with tumor lysate-pulsed dendritic cells elicits antigen-specific, cytotoxic T-cells in patients with malignant glioma. Cancer Res. 2004; 64(14):4973-9. DOI: 10.1158/0008-5472.CAN-03-3505. View

16.

Topalian S, Taube J, Anders R, Pardoll D . Mechanism-driven biomarkers to guide immune checkpoint blockade in cancer therapy. Nat Rev Cancer. 2016; 16(5):275-87. PMC: 5381938. DOI: 10.1038/nrc.2016.36. View

17.

Vatu B, Artene S, Staicu A, Turcu-Stiolica A, Folcuti C, Dragoi A . Assessment of efficacy of dendritic cell therapy and viral therapy in high grade glioma clinical trials. A meta-analytic review. J Immunoassay Immunochem. 2018; 40(1):70-80. DOI: 10.1080/15321819.2018.1551804. View

18.

Prins R, Soto H, Konkankit V, Odesa S, Eskin A, Yong W . Gene expression profile correlates with T-cell infiltration and relative survival in glioblastoma patients vaccinated with dendritic cell immunotherapy. Clin Cancer Res. 2010; 17(6):1603-15. PMC: 3071163. DOI: 10.1158/1078-0432.CCR-10-2563. View

19.

Artene S, Turcu-Stiolica A, Ciurea M, Folcuti C, Tataranu L, Alexandru O . Comparative effect of immunotherapy and standard therapy in patients with high grade glioma: a meta-analysis of published clinical trials. Sci Rep. 2018; 8(1):11800. PMC: 6081409. DOI: 10.1038/s41598-018-30296-x. View

20.

Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015; 350:g7647. DOI: 10.1136/bmj.g7647. View