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ECCO-ESMO: Vaccine Shows Promise in Ovarian Cancer


This report is part of a 12-month Clinical Context series.
By Ed Susman, Contributing Writer, MedPage Today
Published: September 26, 2011
Reviewed by Vandana G. Abramson, MD; Assistant Professor of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee.
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Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.


Explain that patients with advanced ovarian cancer who received an autologous dendritic cell vaccination after cytoreductive surgery and polychemotherapy had a significant improvement in overall survival compared with control groups.
STOCKHOLM – In preliminary studies, women diagnosed with advanced ovarian cancer who received an autologous dendritic cell vaccine appear to achieve extended survival benefits, researchers reported here.
One-year survival was about 89% in patients who received a vaccine pulsed with lysate of tumor cells; and about 93% in the patients who received the cells pulsed with Bacillus subtilis B-7025 cytotoxic lectins (LTCCL), (P<0.05), said Natalia Khranovska, MD, an oncologist at the National Cancer Institute of Ukraine in Kiev.

Those figures compared with about 80% one-year survival in the control group Khranovska said at a poster presentation at the European Multidisciplinary Cancer Conference, formerly known as the Congress of the European Cancer Organizations and Congress of the European Society for Medical Oncology.

Two-year survival was 20.5% in the control group, 47.8% among the lysate of tumor cell infused group and 53.1% of the LTCCL vaccine group (P<0.01), Khranovska told MedPage Today.

Three-year survival was 13.2% in the control group, 26.7% in the lysate of tumor cell group, and 39.8% of the patients receiving the LTCCL vaccine (P<0.05).

"There was clear evidence of clinical benefit of vaccine therapy by dendritic cells pulsed with lysate of tumor cells with cytotoxic lectins for advanced ovarian cancer." Khranovska said.

Another researcher exploring an autologous vaccine for ovarian cancer, Janne Kærns, MD, of Oslo University Radiumhospital in Oslo, Norway, told MedPage Today that the "Ukraine work is interesting but it is very early in the process.

"We have seen that vaccine approaches have been helpful in melanoma and prostate cancer, so it is possible it will be effective in advanced ovarian cancer as well. It is a developing field," said Kærns.

Khranovska explained that her team embarked on the vaccine development based on previous studies. She said that many researchers have tried to enhance methods of loading dendritic cells with tumor antigens.

"Our preclinical findings indicate that the lysate from tumor cells exposed to B. subtilis B-7025 cytotoxic lectins (LTCCL) used for dendritic cell loading is a very effective and promising approach," Khranovska said.

She said the aim of the phase I/II study was to determine the clinical and immunological effects of specific immunotherapy with autologous dendritic cells loaded with LTCCL or conventional lysate of tumor cell in advanced ovarian cancer treatment.

In the trial, autologous dendritic cells of monocytic origin were harvested and treated in the laboratory in a process that takes about eight days, said Khranovska. The vaccine was injected in two courses, each consisting of five injections.

The researchers enrolled 81 patients diagnosed with stage III-IV advanced ovarian cancer. The women were eligible for the study if they were in Performance Status 0-1 without autoimmune disorders.

All patients received cytoreductive surgery and six courses of polychemotherapy on a regimen of cisplatin 100 mg/m2 and cyclophosphamide 800 mg/m2.

After chemotherapy, 41 patients received dendritic cell therapy -- 21 women received dendritic cells loaded with lysate of tumor cell and 20 received dendritic cells loaded with the B. subtilis cytotoxic lectins. The groups were similar in age, tumor histology types, disease stage, surgical intervention, and adjuvant chemotherapy, Khranovska said.

In the dendritic cell groups, 78% of the patients were diagnosed with serous histology; in the control group of 40 patients, 67.5% had serous tumors.

In the experimental group, 46.3% of the women underwent suboptimal cytoreduction surgery -- defined as 1-2 cm of residual tumor -- compared with 55% of the control group.

Khranovska said the dendritic vaccine was well tolerated without significant toxicity.

She noted that 95% of the patients who were given dendritic cell injections showed significant antigen-specific immune responses after three to five vaccinations.

Khranovska and Kærns had no disclosures.



Primary source: European Multidisciplinary Cancer Conference
Source reference:
Khranovska N, et al "New dendritic cell vaccine therapy approach: Randomized phase I/II study in III-IV stage ovarian cancer patients" ECCO-ESMO 2011; Abstract 8039.