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@proceedings{759857, author = {Očadlíková, Darina and Zahradová, Lenka and Kovářová, Lucie and Michálek, Jaroslav and Hájek, Roman}, booktitle = {Blood reviews}, keywords = {Multiple myeloma; Id-protein; Vaccine}, language = {eng}, title = {Vaccination of myeloma patients with monoclonal immunoglobulin loaded dendritic cells: preclinical and first clinical results of a phase I/II clinical trial.}, year = {2007} }
TY - CONF ID - 759857 AU - Očadlíková, Darina - Zahradová, Lenka - Kovářová, Lucie - Michálek, Jaroslav - Hájek, Roman PY - 2007 TI - Vaccination of myeloma patients with monoclonal immunoglobulin loaded dendritic cells: preclinical and first clinical results of a phase I/II clinical trial. KW - Multiple myeloma KW - Id-protein KW - Vaccine N2 - Background: Adjuvant immunotherapy with antigen-loaded dendritic cells (DCs) represents a novel and relatively non-toxic treatment modality for multiple myeloma (MM). Malignant cells in MM produce a monoclonal immunoglobulin (idiotypic protein) which is considered a tumor-specific antigen and can be used for the induction of T lymphocytes. To enhance the anti-myeloma immune response, the idiotypic protein (Id-protein) can be loaded into autologous DCs and used for vaccination. Aims: The aim of this study was to evaluate DC-based vaccine preclinically and test the safety and the immune response of the vaccine in patients with MM. Patients and Methods: Pre-clinical testing was performed in 8 patients with MM. DC loaded with autologous myeloma cells were used for autologous T cell stimulation in vitro. After succesful preclinical testing, we have vaccinated 4 patients with stable disease or asymptomatic slow progressive disease according to EBMT criteria. Patients were pre-treated with high-dose chemotherapy and auto-PBSCT. DC precursors were isolated as an adherent fraction from peripheral blood of the myeloma patients. DCs were prepared in vitro and loaded with Id-protein under GMP conditions as previously described (Ocadlikova et al.Med Oncol 2006, 23: 377-384). Patients were vaccinated every 4 weeks subcutaneously with 6 doses, each containing 1,46-18,1 e 06 (mean 9,52 e 06) DCs. The immune response was evaluated by flow cytometry, Elispot and the skin test of hypersensitivity. Results: IFN-gamma production of T cells stimulated with autologous myeloma cell loaded DC was observed. After successful pre-clinical testing a clinical phase I/II trial was initiated. A total of 24 vaccines were applied to 4 patients so far (January 2007). The viability, number and functional characteristics of in vitro matured DCs loaded with Id-protein were satisfactory with 50,10-99,3% (mean 87,08%) of HLADR/CD86+ cells. Each vaccination was well tolerated with only mild fever in 1 patient. No grade II-IV. toxicity appeared. The clinical trial is ongoing and a total of 12 patients is planned to be evaluated. Conclusions: Vaccination with Id-protein loaded autologous dendritic cells demonstrates feasibility and safety in patients with multiple myeloma pre-treated with high dose chemotherapy. ER -
OČADLÍKOVÁ, Darina, Lenka ZAHRADOVÁ, Lucie KOVÁŘOVÁ, Jaroslav MICHÁLEK and Roman HÁJEK. Vaccination of myeloma patients with monoclonal immunoglobulin loaded dendritic cells: preclinical and first clinical results of a phase I/II clinical trial. In \textit{Blood reviews}. 2007. ISSN~0006-4971.
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