What are dendritic cells, and why are they useful?

Dendritic cells are in every person’s bloodstream and is a blood cell. They normally function as an immune cell but are present in very small numbers, somewhat like an elite force. Their usual function is to identify a foreign substance, including cancer cells, and process the bits of such foreign substances and then jumpstart the the immune response by bringing the foreign substance to the attention of the rest of the immune system (mostly T lymphocyte cells). The activated immune system is then able to circulate throughout the body and destroy the cancer cells.

What kind of cancers can be treated with Dendritic Cell therapy?

Theroretically all cancers can be treated, but experience tells us that certain cancers such as melanoma and kidney cancer should respond best. To date, therapeutic benefit has been documented in B cell lymphoma, myeloma, melanoma, prostate cancer, colon cancer, ovarian cancer, breast cancer, and renal cell cancer amongst others. If interested, patients should seek professional advice on specific cancer and DC therapy and carefully weigh their treatment options. There are currently active trials using DC therapy in melanoma and kidney cancer.

At what cancer stage should a patient consider Dendritic Cell therapy?

A patient can consider Dendritic Cell therapy when all other options have been exhausted, or if the disease is stable and the patient is not on any chemo or radiation therapies concurrently, or if the patient is free of disease but at risk for recurrence and is seeking to potentially reduce the likelihood of cancer reoccurrence. In general, patient should generally seek professional advice on specific cancers and carefully weigh treatment options before proceeding with specific therapy.

Can leukemias/lymphomas be treated with Dendritic Cell therapy?

Research is now progressing in these areas, but patients should seek professional advice on specific cancers and carefully consider their treatment. (See review)

Can childhood tumors be treated with Dendritic Cell therapy?

Yes, and experience is accumulating in this area. Patient’s guardians should seek professional advice on specific cancers regarding DC therapy and carefully weigh their treatment options (See review)

Can brain cancers be treated with Dendritic Cell therapy?

Yes, and there are trials in this area at the present. Patients should seek professional advice and weigh their treatment options. (See review)

Does one need to have one’s own fresh or frozen tumor tissue available to do Dendritic Cell Therapy?

Not always. Some trials require it and it is advisable to have tissue or related antigen available if one is to do Dendritic Cell Therapy for preventative purposes as there may not be sufficient tumor antigen in the circulation for the Dendritic Cells to pick up. However, if patients with advanced or metastatic disease, it is often possible to do “unloaded” Dendritic Cell therapy, where naked Dendritic cells are injected intratumorally or into the bloodstream where it would pick up antigens in vivo. One example of this approach in treating pancreas and gallbladder cancer was presented in ASCO ’04.

How effective is Dendritic Cell therapy in cancer?

Responses have generally been reported to be in the 20% range for heavily pre-treated otherwise untreatable late stage patient, depending on the type of cancer and the functional status of the patient. A larger percentage may not experience remission as such but remain stable with treatment. If seriously interested in the treatment, one should look into available trials, consider a consultation with a reputable and knowledgeable physician or at a treatment center to discuss prognosis and possible outcome as well as details relating to the therapy.

Are any drugs or procedures used as part of the Dendritic Cell Therapy?

Immune adjuvants are used to enhance or modulate the immune system during Dendritic Cell therapy. Such agents may include cytokines such as IL-2, GM-CSF, interferon; drugs such as ribavirin, thalidomide, low dose cyclophosphamide; as well as keyhold limpet hemocyanin (KLH), Bacillus Calmette Guerein (BCG), QS21, Montanide ISA-51. Procedures such as hyperthermia and ozone therapy are sometimes used as adjuvants as well.

Is Dendritic Cell Therapy safe?

Multiple early phases of Dendritic Cell therapy for cancer has been completed and establishes the treatment as generally safe.

Are there any contraindications to Dendritic Cell Therapy?

Recent radiation and chemotherapy which tends to depress the immune system are relative contraindications to Dendritic Cell therapy. Immunologic testing can better establish the condition of the immune system to help physicians determine if a patient is a good candidate for Dendritic Cell therapy. Recent blood transfusions, active autoimmune disease as well as pregnancy are also possible contraindications. Contraindications should be carefully discussed and reviewed with the consulting physician before proceeding.

Are there any clinical trials I can take part in?

There are a number of domestic trials in the US as well as start-up elsewhere in the world that you may qualify for, particularly for melanoma, renal cell cancer, and other solid tumors and leukemias as well. You should refer to our clinical trials section for more information to see if you are eligible.

What if a patient is not qualified for any active trials?

One can consider private treatment in Europe or elsewhere out of a trial setting is one is not eligible for clinical trials. If seriously interested or you need help in sorting out the pros and cons of various trials vs. private treatments as well as the details of the actual Dendritic Cell therapy protocols involved, one should consider a consultation with a reputable and knowledgeable physician to discuss choice of trials, prognosis and possible outcome as well as logistical details relating to Dendritic Cell therapy.

Is Dendritic Cell Therapy an expensive treatment?

If one enrolled in a clinical trial, the treatment itself should be free. If one opts to be treated privately, the treatment cost is comparable with other forms of cancer therapies (eg chemotherapy or newer targeted molecular therapies) and is generally under US 5,000 per treatment course depending on the center.

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