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Nesselhut J, Lorenzen DR, Marx D, Chang RY, Matthes C, Hildenbrand B, Schneider EM, Nesselhut T. Cellular immune suppression in cancer patients and its implication for dendritic cell therapy. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3028 Background: The treatment of human cancer with monocyte-derived dendritic cells (MoDC) is a promising and innovative approach. However, many of the treated patients fail to respond to therapy. The reduced clinical antitumor response may be due to an inflammatory immune-suppressive tumor microenvironment. Regulatory T-cells (T-reg) and other cells with suppressive potential can promote an immune suppressive tumor microenvironment and thus play an important role in regulation of the immune response. Methods: Whole blood from n=100 cancer patients with various tumor types and from n=30 healthy donors were analysed by flow cytometry. CD4+ lymphocytes with immune suppressive potential were characterized by analysing the expression of CD25, CD39, CD127. Results: We found a significantly higher proportion of CD25+/CD39+ and of CD25+/CD127low T-helper cells in the blood of cancer patients as compared to healthy donors. This may indicate two different types of T-reg involved in immune suppression in cancer patients. Treatment of patients with metronomic chemotherapy induced a down-regulation of these cells. Interestingly, we found a subpopulation of cells within the lymphocyte gate characterized by CD2high and CD86 expression in cancer patients with very advanced stage, similar to such normally found in hemaphagocytic lymphohistiocytosis (HLH) patients characterized by exceeding high plasma concentration of IFN-g and IL-10 (Schneider et al. 2002). These cells can be down-regulated by treatment with a tetradecapeptide (Ezrin) known to act as an immune modulator with anti-viral activity leading to reduction of inflammatory cytokines. Conclusions: An efficient induction of a clinical antitumor response requires both a polarization of MoDC in a TH1 direction as well as changing an immune suppressive tumor microenvironment. For the first time, we identified HLH associated cells in advanced cancer patients. As HLH is characterized by hyperinflammation, these cells may indicate an inflammatory tumor microenvironment. Thus, anti-inflammatory therapy should be considered as co-treatment with immunotherapy with dendritic cells for down-regulation of immune suppressive cells (T-reg, CD2high/CD86+ cells) to promote a clinical antitumor response. No significant financial relationships to disclose.
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Affiliation(s)
- J. Nesselhut
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
| | - D. R. Lorenzen
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
| | - D. Marx
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
| | - R. Y. Chang
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
| | - C. Matthes
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
| | - B. Hildenbrand
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
| | - E. M. Schneider
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
| | - T. Nesselhut
- Institute for Tumor Therapy, Duderstadt, Germany; Meridian Medical Group, New York, NY; Clinic for Tumor Biology, Freiburg, Germany; University Hospital Ulm, Ulm, Germany
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Nesselhut J, Nesselhut T, Chang R, Marx D, Brockmann W, Wilke I, Matthes C, Lorenzen D, Stücker W, Peters H, Lüke W. Dendritic cell therapy in glioblastoma multiforme. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3065 Background: Malignant brain tumors belong to the tumors with unfavorable prognosis. The most aggressive form, glioblastoma multiforme (GBM WHO grade IV glioma), is categorized as incurable with median survivals less than 12–18 months and 90–95% of patients surviving less than 2 years. Here we show that immunotherapy with monocyte-derived dendritic cells (MoDC) can induce a clinical response in advanced GMB, especially when combined with the non human pathogenic oncolytic virus NDV (New Castle Disease Virus). Methods: After isolating monocytes from peripheral blood of n=21 patients dendritic cells were generated ex vivo in the presence of recombinant cytokines (IL-4, GM-CSF) and 2,5% autologous serum. If tumor tissue was available the MoDC were primed on day 5 with tumor- lysate and co-cultured with poly:IC and IFN-alpha. The MoDC were harvested on day 7 of culture and administered to the patients, intradermally. In 5 patients NDV was added to the MoDC for one hour prior to administration. These patients received an infusion with NDV one day before vaccination. Results: We were able to induce a clinical response in 33% (n=7) of the treated patients. The median survival after onset of DC-therapy was 10 months. With respect to primary diagnosis the median survival was 19 months with 1- and 2-years survival rates of 81% and 14%, respectively. Improvement of the clinical response can be observed by combination of NDV. None of the 5 patients treated with this combination therapy died of the disease (9–19 months after primary diagnosis). Three of them (60%) show a response with 2 clear partial remissions (40%). Conclusions: Taken together, a dendritic-cell based therapy can be successful in the treatment of GBM. Enhancement of the therapeutically outcome can be induced by a combination therapy with New Castle Disease Virus leading to the suggestion that there may be an interaction between the dendritic cells and the NDV. No significant financial relationships to disclose.
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Affiliation(s)
- J. Nesselhut
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - T. Nesselhut
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - R. Chang
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - D. Marx
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - W. Brockmann
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - I. Wilke
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - C. Matthes
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - D. Lorenzen
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - W. Stücker
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - H. Peters
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
| | - W. Lüke
- Institute for Tumortherapy, Duderstadt, Germany; Meridian Medical Group New York, New York, NY; Institute for Radiology Oncolight, Hamburg, Germany; Research Center of Medical and Biotechnology, Bad Langensalza, Germany; IOZK, Cologne, Germany; University of Göttingen, Göttingen, Germany; IOZK, German Primate Center, Göttingen, Germany
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Nesselhut T, Matthes C, Marx D, Chang RY, Nesselhut J, Cillien N, Lorenzen DR, Gorter R, Stücker W, Peters JH. Cancer therapy with immature monocyte-derived dendritic cells in patients with advanced breast cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- T. Nesselhut
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - C. Matthes
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - D. Marx
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - R. Y. Chang
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - J. Nesselhut
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - N. Cillien
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - D. R. Lorenzen
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - R. Gorter
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - W. Stücker
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
| | - J. H. Peters
- Inst for Tumortherapy, Duderstadt, Germany; Meridian Medcl Group, New York, NY; Univ of CA, San Franzisco, CA; Medcl Ctr Cologne, Köln, Germany; Univ of Göttingen, Göttingen, Germany
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