Personalized dendritic cell vaccine in multimodal individualized combination therapy improves survival in high-risk pediatric cancer patients

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Authors

KÝR Michal MÚDRY Peter POLÁŠKOVÁ Kristýna ZDRAŽILOVÁ DUBSKÁ Lenka DEMLOVÁ Regina KUBÁTOVÁ Jana HLAVÁČKOVÁ Eva ČERNÁ PILÁTOVÁ Kateřina MAZANEK Pavel VEJMĚLKOVÁ Klára DUŠEK Vítězslav TINKA Pavel BALÁŽ Martin MERTA Tomáš KUTTNEROVÁ Zuzana TUREKOVÁ Terézia PAVELKA Zdeněk POKORNÁ Petra PÁLOVÁ Hana MLNAŘÍKOVÁ Marie JEŽOVÁ Marta KELLNEROVÁ Renata KOZAKOVA Sarka SLABÝ Ondřej VALÍK Dalibor ŠTĚRBA Jaroslav

Year of publication 2024
Type Article in Periodical
Magazine / Source International journal of cancer
MU Faculty or unit

Faculty of Medicine

Citation
Web https://onlinelibrary.wiley.com/doi/10.1002/ijc.35062
Doi http://dx.doi.org/10.1002/ijc.35062
Keywords cancer vaccine; immunotherapy; metronomic chemotherapy; N-of-1; rare cancer
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Description A lot of hope for high-risk cancers is being pinned on immunotherapy but the evidence in children is lacking due to the rarity and limited efficacy of single-agent approaches. Here, we aim to assess the effectiveness of multimodal therapy comprising a personalized dendritic cell (DC) vaccine in children with relapsed and/or high-risk solid tumors using the N-of-1 approach in real-world scenario. A total of 160 evaluable events occurred in 48 patients during the 4-year follow-up. Overall survival of the cohort was 7.03 years. Disease control after vaccination was achieved in 53.8% patients. Comparative survival analysis showed the beneficial effect of DC vaccine beyond 2 years from initial diagnosis (HR = 0.53, P = .048) or in patients with disease control (HR = 0.16, P = .00053). A trend for synergistic effect with metronomic cyclophosphamide and/or vinblastine was indicated (HR = 0.60 P = .225). A strong synergistic effect was found for immune check-point inhibitors (ICIs) after priming with the DC vaccine (HR = 0.40, P = .0047). In conclusion, the personalized DC vaccine was an effective component in the multimodal individualized treatment. Personalized DC vaccine was effective in less burdened or more indolent diseases with a favorable safety profile and synergized with metronomic and/or immunomodulating agents.
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