ABSTRACT
Immunotherapeutic approaches, including adoptive cell therapy, revolutionized treatment in multiple myeloma (MM). As dendritic cells (DCs) are professional antigen-presenting cells and key initiators of tumor-specific immune responses, DC-based immunotherapy represents an attractive therapeutic approach in cancer. The past years, various DC-based approaches, using particularly ex-vivo-generated monocyte-derived DCs, have been tested in preclinical and clinical MM studies. However, long-term and durable responses in MM patients were limited, potentially attributed to the source of monocyte-derived DCs and the immunosuppressive bone marrow microenvironment. In this review, we briefly summarize the DC development in the bone marrow niche and the phenotypical and functional characteristics of the major DC subsets. We address the known DC deficiencies in MM and give an overview of the DC-based vaccination protocols that were tested in MM patients. Lastly, we also provide strategies to improve the efficacy of DC vaccines using new, improved DC-based approaches and combination therapies for MM patients.
Subject(s)
Dendritic Cells/immunology , Immunotherapy , Multiple Myeloma/immunology , Multiple Myeloma/therapy , Animals , Antigens, Neoplasm , Biomarkers , Cancer Vaccines , Cell Plasticity/immunology , Clinical Decision-Making , Combined Modality Therapy , Dendritic Cells/metabolism , Disease Management , Disease Susceptibility , Humans , Immunomodulation , Immunotherapy/adverse effects , Immunotherapy/methods , Multiple Myeloma/diagnosis , Multiple Myeloma/mortality , Treatment Outcome , VaccinationABSTRACT
Presentamos el caso de una mujer con enfermedad de Paget extramamaria gigante, de localización perianal. Dada la edad de la paciente, la localización y el gran tamaño del tumor, se indicó tratamiento con radioterapia. Concluimos que ésta constituye una buena alternativa terapéutica, que debe tenerse en cuenta en los pacientes de edad avanzada o con tumores inoperables (AU)
