title: Dendritic cell based tumor vaccination in prostate and renal cell cancer: a systematic review and meta-analysis.
abstract: BACKGROUND
  More than 200 clinical trials have been performed using dendritic cells (DC) as cellular adjuvants in cancer. Yet the key question whether there is a link between immune and clinical response remains unanswered. Prostate and renal cell cancer (RCC) have been extensively studied for DC-based immunotherapeutic interventions and were therefore chosen to address the above question by means of a systematic review and meta-analysis.
  
  
  RESULTS
  Data was obtained after a systematic literature search from clinical trials that enrolled at least 6 patients. Individual patient data meta-analysis was performed by means of conditional logistic regression grouped by study. Twenty nine trials involving a total of 906 patients were identified in prostate cancer (17) and RCC (12). Objective response rates were 7.7% in prostate cancer and 12.7% in RCC. The combined percentages of objective responses and stable diseases (SD) amounted to a clinical benefit rate (CBR) of 54% in prostate cancer and 48% in RCC. Meta-analysis of individual patient data (n = 403) revealed the cellular immune response to have a significant influence on CBR, both in prostate cancer (OR 10.6, 95% CI 2.5-44.1) and in RCC (OR 8.4, 95% CI 1.3-53.0). Furthermore, DC dose was found to have a significant influence on CBR in both entities. Finally, for the larger cohort of prostate cancer patients, an influence of DC maturity and DC subtype (density enriched versus monocyte derived DC) as well as access to draining lymph nodes on clinical outcome could be demonstrated.
  
  
  CONCLUSIONS
  As a 'proof of principle' a statistically significant effect of DC-mediated cellular immune response and of DC dose on CBR could be demonstrated. Further findings concerning vaccine composition, quality control, and the effect of DC maturation status are relevant for the immunological development of DC-based vaccines.
authors.affiliation: Laboratory for Tumor and Transplantation Immunology, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Draube
authors.forename: Nela
authors.initials: N
authors.lastname: Klein-González
authors.forename: Stefanie
authors.initials: S
authors.lastname: Mattheus
authors.forename: Corinne
authors.initials: C
authors.lastname: Brillant
authors.forename: Martin
authors.initials: M
authors.lastname: Hellmich
authors.forename: Andreas
authors.initials: A
authors.lastname: Engert
authors.forename: Michael
authors.initials: M
authors.lastname: von Bergwelt-Baildon
mesh_terms: D019496:Cancer Vaccines / Q000008:administration & dosage*; D002292:Carcinoma, Renal Cell / Q000276:immunology* / Q000628:therapy; D003713:Dendritic Cells / Q000276:immunology*; D006801:Humans; D007167:Immunotherapy; D007680:Kidney Neoplasms / Q000276:immunology* / Q000628:therapy; D008297:Male; D011471:Prostatic Neoplasms / Q000276:immunology* / Q000628:therapy; D011786:Quality Control
chemical_list: D019496:Cancer Vaccines