신세포암의 자가 동종 종양세포 및 동종 또는 공여자 수지상세포 혼합백신의 개발 및 적용
Development and Application of Mixed Vaccines in Renal Cell Carcinoma: Combining Autologous Tumor Cells with Dendritic Cells Derived from Autologous or Allogeneic Origin
박동수, 조효진, 한만용, 이선주, 오도연, 황성규,
소속 상세정보
박동수 ( Park Dong-Soo )
포천중문의과대학교 비뇨기과학교실
조효진 ( Cho Hyo-Jin )
포천중문의과대학교 임상의학연구소
한만용 ( Han Man-Yong )
포천중문의과대학교 임상의학연구소
이선주 ( Lee Sun-Ju )
포천중문의과대학교 임상의학연구소
오도연 ( Oh Do-Yeun )
포천중문의과대학교 임상의학연구소
황성규 ( Hwang Seong-Kyu )
포천중문의과대학교 임상의학연구소
KMID : 0358320070480020111
Abstract
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 & 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.
Conclusion: 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. (Korean J Urol 2007;48:111-119)
키워드
Carcinoma; renal cell; Vaccines
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