Development and Application of Mixed Vaccines in Renal Cell Carcinoma: Combining Autologous Tumor Cells with Dendritic Cells Derived from Autologous or Allogeneic Origin / 대한비뇨기과학회지

PURPOSE: To evaluate the effects of autologous tumor vaccine alone or in combination with dendritic cell vaccines, as a method of stimulating antigen-presenting cells in patients with a locoregionally confined renal cell carcinoma (RCC) or metastatic disease. MATERIALS AND METHODS: Twenty-seven patients with RCC pathological stages II to IV were treated with autologous tumor cell vaccine, either with or without dendritic cell vaccine. Interleukin 2 (IL-2) based immunotherapy was also applied to the patients with metastatic disease. Immunomagnetic beads were used to isolate CD14+ monocytes from patient or donor in dendritic cell preparations. IL-4 and granulocyte-macrophage colony stimulating factor (GM-CSF) were used for maturation of dendritic cells. Flow cytometry evaluations were performed for dendritic cell maturation and changes in the immunological profiles following our treatment. RESULTS: Both the isolation of CD14+ monocyte, using Immunomagnetic beads, and the maturation of dendritic cells, using IL-4 and GM-CSF stimulation, were effective. Tumor immunological profiles showed increased CD3 and CD56 populations after treatment. Side effects related with vaccine were minimal and tolerable. Patients were stratified by the purpose for the vaccination; 8 patients for post-nephrectomy adjuvant therapy and 19 for adjuvant immunotherapy of a metastatic disease. All 8 patients in the former showed a disease free state, while only one of the 19 in the latter group remained in complete remission, while 6 showed short-term responses. CONCLISIONS: Autologous RCC vaccine, combined with or without dendritic cell vaccine, might be effective in the suppression of tumor recurrence in locoregionally confined RCC, although a longer follow-up will be required. These vaccines should be further developed to reach their therapeutic purpose in metastatic RCC.

Application of Autologous Tumor Vaccine as an Adjuvant Immunotherapy in the Treatment of Metastatic Renal Cell Carcinoma / 대한비뇨기과학회지

About 50% of renal cell carcinoma patients initially present with a regional or distant metastatic disease. Attempts to treat metastatic renal cell carcinomas have been directed at cytokine-based immunotherapy. Response rates of interleukin-2-based immunotherapy of 5 to 29% have been reported in this disease. Immunization as a mechanism to recruit host antitumor responses is increasingly being described as a potentially effective and less toxic approach for the treatment of metastatic and high-risk primary cancers. An autologous renal cell cancer vaccine has been applied at our institution for the prevention of recurrence or metastasis in locally advanced cases for more than one year. Herein, two metastatic renal cell carcinoma cases, which failed to show a response to initial immunotherapy or chemoradiotherapy, which were successfully treated with IL-2 (Aldesleukin) and interferon-alpha as autologous cancer vaccine adjuvants is reported.