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Cáncer de Próstata

Substantial remission of prostate adenocarcinoma with dendritic cell therapy APCEDENR in combination with Chemotherapy

Cancer type: Prostate adenocarcinoma. PSA level of 82.17 ng/ml with a GLEASON score of 8 and classified as T1cN1M1b stage of prostate cancer.

Patient conditions: A 63-year-old male with metastatic prostate adenocarcinoma and previous failed treatment history of standard hormonal, chemo, and radiotherapy regimens.

Treatments: Administration of personalized dendritic cell-based vaccine APCEDENR in combination with anthracenedione antineoplastic drug Mitoxantrone. APCEDEN is an autologous DC formulation in which DCs are derived from CD14+ blood monocytes as previously described by Romani et al. and loaded with whole-tumour lysate. Each dose of the vaccine is divided and administered via intravenous and intradermal routes. Six doses of APCEDEN were given at 15-day intervals in a time frame of 3 months.

Results: Substantial remission. More than 60% reduction in size of the lesions in the left para-aortic, mediastinal, and right supraclavicular nodes. Remarkable remission of skeletal metastases. Lower serum PSA level of 8 ng/ml post-APCEDEN.

After dose 4 and 6, the patient showed an increased amount of IFN-γ-expressing CD4+ T lymphocytes along with a decrease in CD4+ and CD8+ Tregs in peripheral blood. However, post-immunotherapy the patient received six cycles of mitoxantrone, an ‘antineoplastic’ or ‘cytotoxic’ chemotherapy drug, from July 2017 to October 2017, as he had an advanced hormone-refractory prostate cancer due to hormonal therapy failure earlier in the treatment history.

Conclusion: The current case report suggests autologous DC immunotherapy could form a safe, feasible and efficacious therapy in combination with the systemic chemotherapy drug mitoxantrone, providing a step forward toward an evolving chemoimmunotherapy approach for cancer treatment. DC vaccine optimization through effective antigen presentation strategies and operational combination therapy strategies are the foci of ongoing and upcoming studies.

Referencia:

Podrazil1 M., Horvath R., Becht E., Rozkova D., Bilkova P., Sochorova K., Hromadkova H., Kayserova J., Vavrova K.,
Lastovicka J., Vrabcova P., Kubackova K., Gasova Z., Jarolim L., Babjuk M., Spisek R., Bartunkova J., Fucikova J.
Phase I/II clinical trial of dendritic-cell based immunotherapy (DCVAC/PCa) combined with chemotherapy in patients with metastatic, castration-resistant prostate cancer
Oncotarget (2015) 6(20), 18192-18205

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