-
What are dendritic cells, and why are
they useful?
- What kind of
cancers can be treated with DC therapy?
- At what cancer
stage should a patient consider DC therapy?
- Can leukemias/lymphomas
be treated with DC therapy?
- Can childhood
tumors be treated with DC therapy?
- Can brain cancers
be treated with DC therapy?
- Does one need
to have one’s own fresh or frozen
tumor tissue available to do DC Therapy?
- How effective
is DC therapy in cancer?
- Are any drugs or procedures used as
part of the DC Therapy?
- Is DC Therapy
safe?
- Are there any
contraindications to DC Therapy?
- Are there any
clinical trials I can take part in?
- What if a patient
is not qualified for any active trials?
- Is DC Therapy
an expensive treatment?
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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