A dendritic cell vaccine administered earlier than and after autologous stem cell transplant (ASCT) was protected and immunogenic and was related to sturdy scientific responses in sufferers with high-risk a number of myeloma, in keeping with analysis printed in Clinical Cancer Research.
“Multiple myeloma is a chronic and incurable cancer,” mentioned Frederick L. Locke, MD, chair of the Blood and Marrow Transplant and Mobile Immunotherapy Division at Moffitt Most cancers Heart and senior creator of the research. “Dendritic cell vaccines have the potential to harness the patients‘ own immune system to get them into remission and potentially keep the cancer from coming back.”
ASCT is often preceded by induction remedy with chemotherapy to kill as many cancer cells as potential and induce a remission. For this research, the investigators chosen sufferers with high-risk illness who nonetheless had energetic myeloma after induction remedy and earlier than receiving ASCT, which constitutes a damaging prognostic issue. “We focused on this patient population because they are most in need of the vaccine,” mentioned Locke.
Dendritic cells are a vital part of the immune system. They take up international proteins, break them down, and current the fragments (peptides) to different immune cells to stimulate an immune response, Locke defined. To supply the vaccine, the researchers engineered the sufferers’ personal dendritic cells to specific survivin and induce an immune response towards the protein.
“High expression of survivin at diagnosis is associated with poor outcomes,” mentioned Locke. “Therefore, we hypothesized that by targeting this protein, we could induce an immune response in patients who have the most aggressive disease and potentially keep them in remission for a longer period of time.”
Locke and colleagues designed a dendritic cell vaccine focusing on a protein known as survivin and examined this vaccine in a section I scientific trial involving 13 sufferers with a number of myeloma. Sufferers obtained one dose of the vaccine inside 30 days earlier than standard-of-care ASCT and one other dose roughly 21 days post-transplant.
To extend the variety of survivin peptides offered to the immune system, and subsequently the chance of triggering a survivin-specific response, Locke and crew engineered the dendritic cells to specific a model of your entire protein, with a mutation to extend security with out compromising immunogenicity.
The vaccine together with ASCT was effectively tolerated, with solely minor hostile results noticed. Moreover, the vaccine induced survivin-specific immune responses. Particularly, circulating survivin-specific CD4 T cells and CD8 T cells considerably elevated in roughly 35% and 30% of sufferers, respectively.
Antibodies towards survivin peptides had been detected in two out of 13 sufferers at baseline and 9 out of 13 sufferers after vaccination and ASCT. “Overall, 85% of patients had either a T-cell response or an antibody response against survivin,” mentioned Locke.
Seven sufferers skilled an improved scientific response at 90 days post-transplant, all of whom confirmed survivin-specific immune responses. After a median follow-up of 4.2 years, six out of those seven sufferers had been alive and remained disease-free after therapy. The estimated four-year progression-free survival was 71%.
“These results compared very favorably to historical data suggesting the four-year progression-free survival of this patient population to be approximately 50%,” mentioned Locke.
“Our study showed that we can target survivin with a vaccine-based approach and induce immune responses, and it suggested that this strategy could ultimately help improve patient outcomes,” added Locke. “Larger, randomized studies are needed to confirm our findings and to assess whether moving vaccination to earlier in the disease course would be beneficial in preventing patients from developing aggressive forms of myeloma.”
The affected person inhabitants on this research will not be typically included prospectively in scientific trials. Moreover, the therapy panorama for myeloma is quickly evolving, with new-generation therapies akin to CAR T-cell remedy and bispecific antibodies being examined earlier than transplant. Due to these elements, there are limitations to instantly evaluating the outcomes from this research to historic knowledge, Locke defined.
As well as, restricted pattern availability didn’t permit the researchers to verify that the noticed vaccine-specific immune responses had been directed towards the sufferers’ personal myeloma cells.
Survivin Dendritic Cell Vaccine Safely Induces Immune Responses and Is Related to Sturdy Illness Management after Autologous Transplant in Sufferers with Myeloma, Scientific Most cancers Analysis (2023). DOI: 10.1158/1078-0432.CCR-22-3987
American Association for Cancer Research
Scientific trial finds dendritic cell vaccine protected, induced immune responses in sufferers with a number of myeloma (2023, September 22)
retrieved 22 September 2023
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