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Sequential intranodal immunotherapy induces antitumor immunity and correlated regression of disseminated follicular lymphoma.
- Source :
-
Blood [Blood] 2015 Jan 01; Vol. 125 (1), pp. 82-9. Date of Electronic Publication: 2014 Oct 07. - Publication Year :
- 2015
-
Abstract
- Advanced stage follicular lymphoma (FL) is incurable by conventional therapies. In the present pilot clinical trial, we explored the efficacy and immunogenicity of a novel in situ immunotherapeutic strategy. Fourteen patients with untreated or relapsed stage III/IV FL were included and received local radiotherapy to solitary lymphoma nodes and intranodal injections of low-dose rituximab (5 mg), immature autologous dendritic cells, and granulocyte-macrophage colony-stimulating factor at the same site. The treatment was repeated 3 times targeting different lymphoma nodes. Primary end points were clinical responses and induction of systemic immunity. Five out of 14 patients (36%) displayed objective clinical responses, including 1 patient with cutaneous FL who showed regression of skin lesions. Two of the patients had durable complete remissions. Notably, the magnitude of vaccination-induced systemic CD8 T-cell-mediated responses correlated closely with reduction in total tumor area (r = 0.71, P = .006), and immune responders showed prolonged time to next treatment. Clinical responders did not have a lower tumor burden than nonresponders pretreatment, suggesting that the T cells could eliminate large tumor masses once immune responses were induced. In conclusion, the combined use of 3 treatment modalities, and in situ administration in single lymphoma nodes, mediated systemic T-cell immunity accompanied by regression of disseminated FL. The trial was registered at www.clinicaltrials.gov as #NCT01926639.<br /> (© 2015 by The American Society of Hematology.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal, Murine-Derived therapeutic use
CD8-Positive T-Lymphocytes cytology
Cancer Vaccines therapeutic use
Dendritic Cells drug effects
Flow Cytometry
Granulocyte-Macrophage Colony-Stimulating Factor therapeutic use
Humans
Middle Aged
Pilot Projects
Positron-Emission Tomography
Recurrence
Remission Induction
Rituximab
Skin Neoplasms therapy
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Immunotherapy methods
Lymph Nodes pathology
Lymphoma, Follicular therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 125
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 25293773
- Full Text :
- https://doi.org/10.1182/blood-2014-07-592162