2018
DOI: 10.1186/s40425-018-0330-1
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Randomized phase II trial of autologous dendritic cell vaccines versus autologous tumor cell vaccines in metastatic melanoma: 5-year follow up and additional analyses

Abstract: BackgroundDespite improved survival following checkpoint inhibitors, there is still a potential role for anti-cancer therapeutic vaccines. Because of biological heterogeneity and neoantigens resulting from each patient’s mutanome, autologous tumor may be the best source of tumor-associated antigens (TAA) for vaccines. Ex vivo loading of autologous dendritic cells with TAA may be associated with superior clinical outcome compared to injecting irradiated autologous tumor cells. We conducted a randomized phase II… Show more

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Cited by 59 publications
(96 citation statements)
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“…The checkpoint and BRAF/MEK inhibitors are immediately available for administration to patients, as they are "off-the-shelf" products, while DC-ATA requires surgical resection of a lesion, and even with current methods, it requires about eight weeks to manufacture the treatment product [20]. Furthermore, the anti-PD-1 and anti-BRAF/MEK products are associated with a high rapid objective response that is based on RECIST, while there were no objective responses in DC-ATA-treated patients per RECIST, although at least one patient did experience durable delayed complete regression of all the measurable sites of disease [18,43]. For these reasons, it does not appear that DC-ATA would displace any of these therapies in the treatment of stage 4 metastatic melanoma, but there is a strong rationale for combining DC-ATA with checkpoint inhibitors, especially in patients who lack an underlying anti-tumor immune response [3,4].…”
Section: Discussionmentioning
confidence: 99%
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“…The checkpoint and BRAF/MEK inhibitors are immediately available for administration to patients, as they are "off-the-shelf" products, while DC-ATA requires surgical resection of a lesion, and even with current methods, it requires about eight weeks to manufacture the treatment product [20]. Furthermore, the anti-PD-1 and anti-BRAF/MEK products are associated with a high rapid objective response that is based on RECIST, while there were no objective responses in DC-ATA-treated patients per RECIST, although at least one patient did experience durable delayed complete regression of all the measurable sites of disease [18,43]. For these reasons, it does not appear that DC-ATA would displace any of these therapies in the treatment of stage 4 metastatic melanoma, but there is a strong rationale for combining DC-ATA with checkpoint inhibitors, especially in patients who lack an underlying anti-tumor immune response [3,4].…”
Section: Discussionmentioning
confidence: 99%
“…In a subsequent randomized phase 2 trial, the DC-ATA was superior to an irradiated autologous tumor cell vaccine that was also admixed with GM-CSF [17]. Long-term follow-up confirmed a doubling of median survival from 20.5 to 43.4 months, a higher observed survival rate at three years of 61% vs. 25%, and a 70% reduction in the risk of death [18].…”
Section: Introductionmentioning
confidence: 92%
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