Review of clinical studies on dendritic cell-based vaccination of patients with malignant melanoma: assessment of correlation between clinical response and vaccine parameters

  • Lotte Engell-Noerregaard
  • Troels Holz Hansen
  • Mads Hald Andersen
  • Per thor Straten
  • Inge Marie Svane


During the past years numerous clinical trials have been carried out to assess the ability of dendritic cell (DC) based immunotherapy to induce clinically relevant immune responses in patients with malignant diseases. A broad range of cancer types have been targeted including malignant melanoma which in the disseminated stage have a very poor prognosis and only limited treatment options with moderate effectiveness. Herein we describe the results of a focused search of recently published clinical studies on dendritic cell vaccination in melanoma and review different vaccine parameters which are frequently claimed to have a possible influence on clinical response. These parameters include performance status, type of antigen, DC maturation status, route of vaccine administration, use of adjuvant, and vaccine induced immune response. In total, 38 articles found through Medline search, have been included for analysis covering a total of 626 patients with malignant melanoma treated with DC based therapy. Clinical response (CR, PR and SD) were found to be significantly correlated with the use of peptide antigens (p = 0.03), the use of any helper antigen/adjuvant (p = 0.002), and induction of antigen specific T cells (p = 0.0004). No significant correlations between objective response (CR and PR) and the tested parameters were found. However, a few non-significant trends were demonstrated; these included an association between objective response and use of immature DCs (p = 0.08), use of adjuvant (p = 0.09), and use of autologous antigen preparation (p = 0.12). The categorisation of SD in the response group is debatable. Nevertheless, when the SD group were analysed separately we found that SD was significantly associated with use of peptide antigens (p = 0.0004), use of adjuvant (p = 0.01), and induction of antigen specific T cells (p = 0.0003). No specific route of vaccine administration showed superiority. Important lessons can be learned from previous studies, interpretation of these findings should, however, be done with reservation for the many minor deviations in the different treatment schedules among the published studies, which were not considered in order to be able to process and group the data.


Cancer Dendritic cells Malignant melanoma Immunotherapy Tumour vaccines 



Complete response


Partial response


Stable disease


Progressive disease


Mixed response


No evidence of disease


Not evaluable






Number of patients


Reference number


Autologous tumour lysate


Autologous tumour homogenate


Allogeneic tumour lysate


Autologous tumour cells, NA17-A and Colo 829 are tumour cell lines


Keyhole limpet haemocyanin


Flu-matrix protein


Hepatitis B surface protein


Hepatitis B antigen




Tetanus toxoid


Monocyte-derived conditioned medium


Malignant melanoma


Peripheral blood mononuclear cells


Granulocyte/macrophage-colony stimulating factor




Tumour necrosis factor




Prostaglandin E2


Complete medium




Immature dendritic cells


Mature dendritic cells












No new lesions


Not defined










GM-CSF + IL-13


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Lotte Engell-Noerregaard
    • 1
    • 2
  • Troels Holz Hansen
    • 2
  • Mads Hald Andersen
    • 2
  • Per thor Straten
    • 2
  • Inge Marie Svane
    • 1
    • 2
  1. 1.Department of OncologyHerlev HospitalHerlevDenmark
  2. 2.Department of Hematology, Center for Cancer Immune Therapy (CCIT)Herlev HospitalHerlevDenmark

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