title: Dendritic cell vaccination in medullary thyroid carcinoma.
abstract: OBJECTIVE
  Prognosis and treatment effectiveness for medullary thyroid carcinoma (MTC) are strictly related to tumor stage. Palliative treatment options show no significant benefit. A promising treatment approach for human cancer is based on the vaccination of autologous dendritic cells (DCs).
  
  
  METHODS
  The objective of this study was to evaluate the effectiveness of DC vaccines in MTC patients. Therefore, we generated autologous tumor lysate-pulsed DCs from 10 patients suffering from advanced MTC for repeated vaccination. Mature DCs were derived from peripheral blood monocytes by using CD14 magnetic bead selection and subsequent culture in the presence of granulocyte macrophage colony-stimulating factor, interleukin 4, and tumor necrosis factor alpha with or without addition of IFN-gamma. DCs were loaded with tumor lysate and further injected into a groin lymph node. Toxicity, tumor marker profile, immune response, and clinical response were determined.
  
  
  RESULTS
  Vaccination was well tolerated and induced a positive immunological response in all of the tested patients as evaluated by in vivo delayed-type hypersensitivity reactivity or in vitro intracytoplasmic IFN-gamma detection assay. Three patients had a partial response, 1 patient presented a minor response, and 2 patients showed stable disease. The remaining 4 patients had progressive disease.
  
  
  CONCLUSIONS
  These data provide strong evidence that vaccination with tumor-lysate pulsed DCs results in the induction of a specific immune response in patients suffering from MTC. Objective clinical responses could be observed even for far-advanced disease. Therefore, we suggest that MTC is particularly suited for DC-based immunotherapy.
authors.affiliation: Department of Surgery, University of Vienna, Medical School, Vienna, Austria. A.Stift@akh-wien.ac.at
authors.forename: Anton
authors.initials: A
authors.lastname: Stift
authors.forename: Monika
authors.initials: M
authors.lastname: Sachet
authors.forename: Rubina
authors.initials: R
authors.lastname: Yagubian
authors.forename: Clemens
authors.initials: C
authors.lastname: Bittermann
authors.forename: Peter
authors.initials: P
authors.lastname: Dubsky
authors.forename: Christine
authors.initials: C
authors.lastname: Brostjan
authors.forename: Roswitha
authors.initials: R
authors.lastname: Pfragner
authors.forename: Bruno
authors.initials: B
authors.lastname: Niederle
authors.forename: Raimund
authors.initials: R
authors.lastname: Jakesz
authors.forename: Michael
authors.initials: M
authors.lastname: Gnant
authors.forename: Josef
authors.initials: J
authors.lastname: Friedl
mesh_terms: D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood; D019496:Cancer Vaccines / Q000008:administration & dosage* / Q000276:immunology; D002272:Carcinoembryonic Antigen / Q000097:blood; D018276:Carcinoma, Medullary / Q000097:blood / Q000473:pathology / Q000628:therapy*; D003713:Dendritic Cells / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D016219:Immunotherapy, Adoptive / Q000379:methods; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019496:Cancer Vaccines; D002272:Carcinoembryonic Antigen; D002116:Calcitonin