Dendritic cells pulsed with prostate-specific membrane antigen in metastatic castration-resistant prostate cancer patients: a systematic review and meta-analysis

Abstract

BackgroundDendritic cells (DCs) are used in many malignancies as vaccines to induce immunity against specific cancer antigens. The role of DCs in metastatic castration-resistant prostate cancer (mCRPC) is not determined. In this study, the proportion of mCRPC patients with clinically significant response to targeted therapy by DCs pulsed with prostate-specific membrane antigen was evaluated, and the possible adverse effects of this modality were investigated.MethodsMajor databases were searched up to Feb 2017, to identify studies in which the antitumor efficacy of DCs pulsed with the extracellular portion of PSMA was studied for the treatment of mCRPC. Data were collected by two reviewers and analyzed using Comprehensive Meta-Analysis software, version 2.0.FindingsOur study consisted of 6 nonrandomized prospective (cohort) trials, overall reporting on 153 mCRPC patients. The event rate that is the representative of fraction of patients showing antitumor response was 0.43 (95% confidence interval = 0.355–0.512; P = 0.097). No significant between-study heterogeneity or inconsistency was detected (I2 = 5.47; Q = 5; P = 0.382). Our study failed to demonstrate a significant therapeutic efficacy for DCs in mCRPC. However, no significant adverse effects were seen.

The efficacy and safety of immune checkpoint inhibitors in metastatic castration-resistant prostate cancer: A systematic review and meta-analysis

“…mCRPC is not considered curable, thus the current treatment goal is generally prolonging survival as long as possible and increasing patients' quality of lives. [32] Although the treatment scenario of mCRPC has been recently revolutionized by the approval of several agents able to increase survival, [33][34][35] none of these drugs is curative and yields only around 36 months for the median survival. [36,37] Therefore, there is an urgent need for more effective agents, more capable of shrinking visceral and bone lesions, prolonging PFS, and having less adverse effects, in contrast to the conventional chemotherapies.…”

Current approaches to quality assessment, non-clinical and clinical studies of dendritic cell vaccines in oncology

“…Cовременные подходы к оценке качества, проведению доклинических и клинических исследований... выживаемости и выживаемости без прогрессирования [58]. По данным метаанализа, включавшего результаты 6 нерандомизированных КИ вакцинотерапии РПЖ, терапевтический эффект ДКВ не выявлен [59]. В большинстве исследований продемонстрирована безопасность вакцинотерапии у онкологических пациентов, а в ряде случаев было показано развитие иммунного ответа после введения ДКВ [58,59].…”