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Clinical and Developmental Immunology
Volume 2010 (2010), Article ID 504979, 9 pages
http://dx.doi.org/10.1155/2010/504979
Clinical Study

Unexpected High Response Rate to Traditional Therapy after Dendritic Cell-Based Vaccine in Advanced Melanoma: Update of Clinical Outcome and Subgroup Analysis

1Immunotherapy Unit, Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), 47014 Meldola, Italy
2Unit of Biostatistics and Clinical Trials, Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), 47014 Meldola, Italy
3Blood Transfusion Unit, Morgagni-Pierantoni Hospital, 47100 Forlì, Italy
4Thoracic Surgery Unit, Morgagni-Pierantoni Hospital, 47100 Forlì, Italy
5Advanced Oncological Surgery Unit, Morgagni-Pierantoni Hospital, 47100 Forlì, Italy

Received 22 June 2010; Accepted 13 August 2010

Academic Editor: Bernhard Fleischer

Copyright © 2010 Laura Ridolfi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We reviewed the clinical results of a dendritic cell-based phase II clinical vaccine trial in stage IV melanoma and analyzed a patient subgroup treated with standard therapies after stopping vaccination. From 2003 to 2009, 24 metastatic melanoma patients were treated with mature dendritic cells pulsed with autologous tumor lysate and keyhole limpet hemocyanin and low-dose interleukin-2. Overall response (OR) to vaccination was 37.5% with a clinical benefit of 54.1%. All 14 responders showed delayed type hypersensitivity positivity. Median overall survival (OS) was 15 months (95% CI, 8–33). Eleven patients underwent other treatments (3 surgery, 2 biotherapy, 2 radiotherapy, 2 chemotherapy, and 4 biochemotherapy) after stopping vaccination. Of these, 2 patients had a complete response and 5 a partial response, with an OR of 63.6%. Median OS was 34 months (range 16–61). Our results suggest that therapeutic DC vaccination could favor clinical response in patients after more than one line of therapy.