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KÝR, Michal (203 Czech Republic, belonging to the institution), Peter MÚDRY (203 Czech Republic, belonging to the institution), Kristýna POLÁŠKOVÁ (203 Czech Republic, belonging to the institution), Lenka ZDRAŽILOVÁ DUBSKÁ (203 Czech Republic, belonging to the institution), Regina DEMLOVÁ (203 Czech Republic, belonging to the institution), Jana KUBÁTOVÁ (203 Czech Republic, belonging to the institution), Eva HLAVÁČKOVÁ (203 Czech Republic, belonging to the institution), Kateřina ČERNÁ PILÁTOVÁ (203 Czech Republic, belonging to the institution), Pavel MAZANEK (203 Czech Republic), Klára VEJMĚLKOVÁ (203 Czech Republic, belonging to the institution), Vítězslav DUŠEK (203 Czech Republic, belonging to the institution), Pavel TINKA (203 Czech Republic, belonging to the institution), Martin BALÁŽ (703 Slovakia, belonging to the institution), Tomáš MERTA (203 Czech Republic, belonging to the institution), Zuzana KUTTNEROVÁ (703 Slovakia, belonging to the institution), Terézia TUREKOVÁ (703 Slovakia, belonging to the institution), Zdeněk PAVELKA (203 Czech Republic, belonging to the institution), Petra POKORNÁ (203 Czech Republic, belonging to the institution), Hana PÁLOVÁ (203 Czech Republic, belonging to the institution), Marie MLNAŘÍKOVÁ (203 Czech Republic, belonging to the institution), Marta JEŽOVÁ (203 Czech Republic, belonging to the institution), Renata KELLNEROVÁ (203 Czech Republic, belonging to the institution), Sarka KOZAKOVA (203 Czech Republic), Ondřej SLABÝ (203 Czech Republic, belonging to the institution), Dalibor VALÍK (203 Czech Republic, belonging to the institution) and Jaroslav ŠTĚRBA (203 Czech Republic, belonging to the institution)

V originále

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.

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

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