Skip to main content
Log in

Clinical utilization of postoperative dendritic cell vaccine plus activated T-cell transfer in patients with intrahepatic cholangiocarcinoma

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background

The prognosis of patients with intrahepatic cholangiocarcinoma (ICC) is extremely poor and the recurrence rate after curative operation is very high. There is no standard treatment to prevent recurrence of ICC. In this study, we investigated the clinical utilization of a dendritic cell vaccine plus activated T-cell transfer in an adjuvant setting for postoperative ICC.

Methods

36 patients with ICC were vaccinated at least 3 times with autologous tumor lysate pulsed dendritic cells plus ex-vivo activated T-cell transfer. The 5-year progression-free survival (PFS) and overall survival (OS) were measured and compared with those of 26 patients who received the curative operation alone as a concurrent control. The registration number was UMIN000005820.

Results

The median PFS and OS were 18.3 and 31.9 months in the patients receiving adjuvant immunotherapy and 7.7 and 17.4 months in the group receiving surgery alone (p = 0.005 and 0.022, respectively). In the treated group, patients whose skin reactions were 3 cm or more at the vaccine site showed dramatically better prognosis (PFS p < 0.001, OS p = 0.001).

Conclusions

A postoperative dendritic cell vaccine plus activated T-cell transfer would be a feasible and effective treatment for preventing recurrence and achieving long-term survival in ICC patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Yamamoto M, Ariizumi S. Intrahepatic recurrence after surgery in patients with intrahepatic cholangiocarcinoma. J Gastoenterol. 2006;41(9):925–6.

    Article  Google Scholar 

  2. Yamamoto M, Takasaki K, Otsubo T, Katsuragawa H, Katagiri S. Recurrence after surgical resection of intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Surg. 2001;8(2):154–7.

    Article  PubMed  CAS  Google Scholar 

  3. Kotera Y, Shimizu K, Mule JJ. Comparative analysis of necrotic and apoptotic tumor cells as a source of antigen(s) in dendritic cell-based immunization. Cancer Res. 2001;61(22):8105–9.

    PubMed  CAS  Google Scholar 

  4. Shimizu K, Thomas EK, Giedlin M, Mule JJ. Enhancement of tumor-lysate- and peptide-pulsed dendritic cell-based vaccines by the addition of foreign helper protein. Cancer Res. 2001;61(6):2618–24.

    PubMed  CAS  Google Scholar 

  5. Engell-Noerregaard L, Hansen TH, Andersen MH, Straten PT, Svane IM. Review of clinical studies on dendritic cell-based vaccination of patients with malignant melanoma: assessment of correlation between clinical response and vaccine parameters. Cancer Immunol Immunother. 2009;58(1):1–14.

    Article  PubMed  CAS  Google Scholar 

  6. Shimizu K, Tanigawa K, Takeshita N, Fujisawa T, Takasaki K, Yamamoto M, Aruga A. A Phase I/II trial of combination therapy of tumor lysate-pulsed dendritic cells and adoptive transfer of anti-CD3 activated T cells (ATVAC) in patients with advanced gastrointestinal (GI) cancers. J Immunother. 2008;31(9):926.

    Google Scholar 

  7. De Vleeschouwer S, Fieuws S, Rutkowski S, Van Calenbergh F, Van Loon J, Goffin J, Sciot R, Wilms G, Demaerel P, Warmuth-Metz M, Soerensen N, Wolf JEA, Wagner S, Kaempgen E, Van Gool SW. Postoperative adjuvant dendritic cell-based immunotherapy in patients with relapsed glioblastoma multiforme. Clin Cancer Res. 2008;14(10):3098–104.

    Article  PubMed  Google Scholar 

  8. Rutlowski S, De Vleeschouwer S, Kaempgen E, Wolf JEA, Kuhl J, Demaerel P, Warmuth-Metz M, Flamen P, Van Calenbergh F, Plets C, Sorensen N, Opitz A, Van Gool SW. Surgery and adjuvant dendritic cell-based tumour vaccination for patients with relapsed malignant glioma, a feasibility study. Br J Cancer. 2004;91(9):1656–62.

    Google Scholar 

  9. Takayama T, Sekine T, Makuuchi M, Yamasaki S, Kosuge T, Yamamoto J, Shimada K, Sakamoto M, Hirohashi S, Ohashi Y, Kakizoe T. Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomized trial. Lancet. 2000;356(9232):802–7.

    Article  PubMed  CAS  Google Scholar 

  10. Chang AE, Aruga A, Cameron MJ, Sondak VK, Normolle DP, Fox BA, Shu S. Adoptive immunotherapy with vaccine-primed lymph node cells secondarily activated with anti-CD3 and interleukin-2. J Clin Oncol. 1997;15(2):796–807.

    PubMed  CAS  Google Scholar 

  11. Matsuda A, Kuno A, Kawamoto T, Matsuzaki H, Irimura T, Ikehara Y, Zen Y, Nakanuma Y, Yamamoto M, Ohkohchi N, Shoda J, Hirabayashi J, Narimatsu H. Wisteria floribunda agglutinin-positive mucin 1 is a sensitive biliary marker for human cholangiocarcinoma. Hepatology. 2010;52(1):174–82.

    Article  PubMed  CAS  Google Scholar 

  12. Matsumura N, Yamamoto M, Aruga A, Takasaki K, Nakano M. Correlation between expression of MUC1 core protein and outcome after surgery in mass-forming intrahepatic cholangiocarcinoma. Cancer. 2001;94(6):1770–6.

    Article  Google Scholar 

  13. Lepisto AJ, Moser AJ, Zeh H, Lee K, Bartlett D, McKolanis JR, Geller BA, Schmotzer A, Potter DP, Whiteside T, Finn OJ, Ramanathan RK. A phase I/II study of a MUC1 peptide pulsed autologous dendritic cell vaccine as adjuvant therapy in patients with resected pancreatic and biliary tumors. Cancer Ther. 2008;6(B):955–64.

    PubMed  CAS  Google Scholar 

  14. Higuchi R, Yamamoto M, Hatori T, Hatori T, Shimizu K, Imai K, Takasaki K. Intrahepatic cholangiocarcinoma with lymph node metastasis successfully treated by immunotherapy with CD3-activated T cells and dendritic cells after surgery: report of a case. Surg Today. 2006;36(6):559–62.

    Article  PubMed  Google Scholar 

  15. Miyazawa M, Ohsawa R, Tsunoda T, Hirono S, Kawai M, Tani M, Nakamura Y, Yamaue H. Phase I clinical trial using peptide vaccine for human vascular endothelial growth factor receptor 2 in combination with gemcitabine for patients with advanced pancreatic cancer. Cancer Sci. 2010;101(2):422–9.

    Article  Google Scholar 

  16. Koike N, Pilon-Thomas S, Mule JJ. Nonmyeloablative chemotherapy followed by T-cell adoptive transfer and dendritic cell-based vaccination results in rejection of established melanoma. J Immunother. 2008;31(4):402–12.

    Article  PubMed  Google Scholar 

  17. Matsushita N, Pilon-Thomas SA, Martin LM, Riker AI. Comparative methodologies of regulatory T cell depletion in a murine melanoma model. J Immunol Methods. 2008;333(1–2):167–79.

    Article  PubMed  CAS  Google Scholar 

  18. Morse MA, Hobeika AC, Osada T, Serra D, Niedzwiechi D, Lyerly DH, Clay TM. Depletion of human regulatory T cells specifically enhances antigen-specific immune responses to cancer vaccines. Blood. 2008;112(3):610–8.

    Article  PubMed  CAS  Google Scholar 

  19. Fukuma D, Matsuyoshi H, Hirta S, Kurisaki A, Motomura Y, Yoshitake Y, Shinohara M, Nishimura Y, Senju S. Cancer prevention with semi-allogeneic ES cell-derived dendritic cells. Biochem Biophys Res Commun. 2005;335(1):5–13.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the staff of the Liver Surgery Group of the Department of Surgery and the members of the Cell Processing Center of Tokyo Women’s Medical University for their cooperation in the clinical trial. This study was supported in part by a grant form the Nakayama Cancer Research Institute.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Atsushi Aruga.

About this article

Cite this article

Shimizu, K., Kotera, Y., Aruga, A. et al. Clinical utilization of postoperative dendritic cell vaccine plus activated T-cell transfer in patients with intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Sci 19, 171–178 (2012). https://doi.org/10.1007/s00534-011-0437-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-011-0437-y

Keywords

Navigation