Ten-year survival analysis for renal carcinoma patients treated with an autologous tumour lysate vaccine in an adjuvant setting

Abstract

About 30% of renal cell carcinomas (RCC) will develop recurrence after surgery. Despite evidence for a significantly improved survival by autologous tumour cell vaccination therapy, the procedure has not become standard. Between August 1993 and December 1996, 1,267 RCC patients undergoing radical nephrectomy in 84 German hospitals were subsequently treated by autologous tumour cell vaccination therapy. The study group comprised 692 patients with complete follow-up (stages pT2-3, pNx-2, M0 based on the TNM classification, 4th edition). Subsequent propensity-score matching according to 7 defined criteria with 861 control patients undergoing nephrectomy alone without adjuvant treatment at the Carl-Thiem-Hospital Cottbus, resulted in 495 matched pairs. Overall and stage-specific survival rates were analysed after a median follow-up of 131 months. The 5- and 10-year overall survival (OS) rates were 80.6 and 68.9% in the vaccine group and 79.2 and 62.1% in the control group (p = 0.066). Patients with pT3 stage RCC revealed 5- and 10-year OS rates of 71.3 and 53.6% in the study group and 65.4 and 36.2% in the control group (p = 0.022). In multivariable analysis, patients in the vaccine group showed a significantly improved survival both in the whole study group (HR = 1.28, p = 0.030) and in the subgroup presenting with pT3 stage tumours (HR = 1.67, p = 0.011). Adjuvant treatment with autologous vaccination therapy resulted in a significantly improved overall survival in pT3 stage RCC patients, suggesting benefit especially in this subgroup. However, controlled clinical trials integrating the recent TNM classification and further risk constellations are required to define additional patient groups that may derive benefit from this treatment.

DAMPs and PDT-mediated photo-oxidative stress: exploring the unknown

“…22 Apart from this, knowledge about DAMPs can also help us in improving certain vaccination strategies employed against cancer. For instance, 'autologous' (killed) tumour cell based-vaccines 23, 24 and 'autologous' dendritic cell (DC)-based vaccines 25,26 have shown considerable promise mitigated by instances of failures within clinical settings.…”

Adjuvant Therapy for Renal Cell Carcinoma

“…24 The only adjuvant trial with this approach to show a significant benefit in DFS used an autologous RCC lysate vaccine, but the high number of patients lost after randomization (32%), the imbalance of this loss between treatment arms, and the absence of OS data led to criticism of the results 25 ; however, a recent update of the results with 10-year follow up did reveal a benefit in OS, mainly in pT3 patients. 26 Finally, a trial that has recently reported first results is the Adjuvant RENCAREX Ò Immunotherapy trial to Study Efficacy in non-metastasised Renal cell carcinoma trial with girentuximab, a monoclonal antibody that binds the CA-IX cell surface antigen, present in 95% of RCC. This international, randomized, doubleblind phase III trial compared girentuximab with placebo, and enrolled 864 high-risk patients.…”

Victory and Defeat in the Induction of a Therapeutic Response through Vaccine Therapy for Human and Canine Brain Tumors: A Review of the State of the Art

“…34 Subsequently, a review with 10-year follow-up showed that 5-year overall survival of patients with UICC stage 3 disease was 71.9% in patients receiving autologous vaccine versus 60.3% for those who had surgery alone ( p =0.008). 35 …”