title: Changes in circulating dendritic cells and IL-12 in relation to the angiogenic factor VEGF during IL-2 immunotherapy of metastatic renal cell cancer.
abstract: Angiogenesis and immunosuppression are the main biological mechanisms responsible for cancer progression. Moreover, recent observations suggesting a negative influence of angiogenesis on anticancer immunity have shown that some angiogenic factors, such as VEGF, may induce immunosuppression. In addition, the evidence of abnormally high blood levels of VEGF has been proven to be associated with resistance to IL-2 immunotherapy. The present study was performed to establish a possible relation ship between the efficacy of IL-2 cancer immunotherapy and changes in circulating levels of VEGF, IL-12, mature and immature dendritic cells (DC). The study included 25 metastatic renal cell cancer patients who underwent subcutaneous low-dose IL-2 immunotherapy (6 MIU/day for 6 days/week for 4 weeks). Immature and mature DCs were identified as CD123+ and CD11c+ cells, respectively. The clinical response consisted of partial response (PR) in five, stable disease (SD) in 11 and progressive disease (PD) in the remaining nine patients. The mean IL-12 levels observed during IL-2 immunotherapy were significantly higher in patients with PR or SD than in those with PD, whereas the mean VEGF concentrations were significantly higher in patients who had PD than in those with PR or SD. Finally, a significant increase in the mean number of circulating mature DCs occurred only in patients with PR or SD, whereas no significant change was seen in patients with PD. By contrast, no significant change was observed in the mean number of immature DCs. This study shows that the efficacy of IL-2 immunotherapy is associated with a significant increase in circulating mature DCs and IL-12, without any concomitant increase in VEGF concentrations. Further studies will be required to better define the relationship between activation of anticancer immunity and control of angiogenesis-related mechanisms.
authors.affiliation: Division of Radiation Oncology, S. Gerardo Hospital, Monza (MI), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bonfanti
authors.forename: P
authors.initials: P
authors.lastname: Lissoni
authors.forename: R
authors.initials: R
authors.lastname: Bucovec
authors.forename: F
authors.initials: F
authors.lastname: Rovelli
authors.forename: F
authors.initials: F
authors.lastname: Brivio
authors.forename: L
authors.initials: L
authors.lastname: Fumagalli
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D001772:Blood Cell Count; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000473:pathology / Q000628:therapy; D003713:Dendritic Cells; D019008:Drug Resistance, Neoplasm; D016228:Endothelial Growth Factors / Q000097:blood*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D018664:Interleukin-12 / Q000097:blood*; D007376:Interleukin-2 / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy; D008222:Lymphokines / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000097:blood*; D009389:Neovascularization, Pathologic / Q000097:blood*; D010166:Palliative Care; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D014408:Biomarkers, Tumor; D016228:Endothelial Growth Factors; D007155:Immunologic Factors; D007376:Interleukin-2; D008222:Lymphokines; D009363:Neoplasm Proteins; D011994:Recombinant Proteins; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D018664:Interleukin-12