By ecancer reporter Laura Thomas
An autologous tumour lysate-loaded dendritic cell vaccination may increase survival of patients with newly diagnosed glioblastoma by 7.3% and patients with recurrent glioblastoma by 6%, finds a study in JAMA Oncology.
For the study, a phase 3 randomised, double-blind clinical trial was carried out in the US, Canada, the UK, and Germany.
331 patients were included in the trial and randomly assigned in a 2-to-1 ratio to the autologous tumour lysate-loaded dendritic cell vaccination or a placebo. 1,366 patients were included in an external control population.
All patients in the trial also received standard of care - surgery, radiotherapy, and chemotherapy.
The study found that the median OS for those with newly diagnosed glioblastoma was 19.3 months from randomisation and 22.4 months from the time of surgery with DCVax-L, compared to 16.5 months from randomisation in the control arm (HR, 0.80; P = .002).
With patients who had newly diagnosed glioblastoma, the study found that those who took the vaccine had a survival of 13% at 60 months compared to the external control group, which had a survival of 5.7%.
For those patients with recurrent glioblastoma, the study observed that those who got the vaccine had a survival of 11.1% at 30 months compared to the external control group, which had a survival of 5.1%.
Patients who received the vaccine, survived years after the completion of the vaccine course, suggesting the body creates an effective memory immune response.
These results suggest that cancer vaccines may be applicable to a wide range of clinical settings.
The use of dendritic cells as the active agent and antigen delivery method means that a wider immune response can be activated than when using other agents.
The extreme heterogeneity of glioblastoma can be tackled by utilising autologous instead of standardised antigens.
Additionally, the use of autologous antigens can make sure that the treatment targets antigens actually present on the tumour of the patient.
The use of tumour lysate means that the full repertoire of antigens can be targeted. This can prevent the patient’s tumour from mutating around the targeted antigens, which has been observed when only a small number of antigens are targeted.
The study authors suggest that treatment with the vaccine could possibly be used alongside a broad variety of other treatment agents, such as checkpoint inhibitors, targeted therapies, chemotherapies, cytokines, or oncolytic virus therapies.
The vaccine was observed to have a benign safety profile which allows patients who are vulnerable to adverse events to be treated.
In addition, the safety of the vaccine avoids the requirement, and cost, for extra treatment to manage side effects.
Altogether the results of this study suggest that an autologous tumour lysate-loaded dendritic cell vaccination may be a safe and effective method to increase survival of patients with newly diagnosed glioblastoma and patients with recurrent glioblastoma.
Reference: Liau, L.M., Ashkan, K., Brem, S., et al., Association of Autologous Tumor Lysate-Loaded Dendritic Cell Vaccination With Extension of Survival Among Patients With Newly Diagnosed and Recurrent Glioblastoma A Phase 3 Prospective Externally Controlled Cohort Trial. JAMA Oncology. 2022. Doi: 10.1001/jamaoncol.2022.5370
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