This trial evaluates the ability of a novel vaccine to stimulate anti- tumor immune responses and provide therapeutic benefit in an adjuvant setting. The vaccine consists of autologous dentritic cells (professional antigen presenting cells) collected by apharesis, pulsed with individualized tumor idiotype as target, and reinfused into the patient. Ten patients with low grade non-Hodgkin's lymphoma have complete vaccination with four courses of idiotype pulsed autologous dentritic cells. An additional three patients are in the process of being vaccinated and several more are scheduled to start soon. The dentritic cell infusions have been very well tolerated with next to no toxicity. Eight of the initial ten patients have developed measurable anti-idiotype T-cell proliferative responses, suggesting the possibility of an anti-tumor effect. Interestingly, no patients have produced measurable humoral anti-idiotype responses, unlike patients treated with our standard vaccine. We assume that this is due to the fact that these patients have significant residual tumor during vaccination which may prevent any tumor specific antibodies from circulating in the blood. The next series of patients are selected to have minimal residual disease in order to ascertain whether humoral anti-idiotype responses will be elicited. Several patients did experience tumor regressions during and after Dentritic Cell vaccination. Six of the ten patients have developed progressive disease within several years of vaccination, most likely reflecting their poorer prognosis defined by suboptimal response to initial chemotherapy. As the trial continues to accrue, we will have a larger population whose clinical responses can be compared to the expected clinical course for comparable patients.
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