Dendritic Cell Therapy - Emerging Treatment for Cancer

Progress of cancer treatment is continuing evidence of focused determination to battle one of the most challenging diseases. Currently, FDA and European Medical Device Directive approved Dendritic Cell Therapy is a cell-based immunotherapy emerging in India to treat cancer. Dr. Sumana Prem Kumar, Consultant Radiation Oncologist at Chennai Meenakshi Multi Speciality Hospital and Mrs. Devi Srinivasa Raghavan, recipient of DENVAX and Ovarian Cancer Survivor, speak to Medindia on the developments of the therapy.

On Cancer and Therapies

Cancer occurs when the immunity of a human body decreases and the WBC (White Blood Corpuscles) in the body cannot restrain the cancer cell. When the WBCs fail to function, the foreign body cells multiply erratically at a rapid pace. These irregularly breeding abnormal cells are known as cancer cells. Hence cancer arises, when the WBCs do not have the capacity to fight against the foreign cells and secondly are not able to recognize the foreign cells. Known treatments for cancer include surgery, chemotherapy, radiation therapy and the recent advancement, immunotherapy.

Dendritic Cell Vaccine

Dendritic Cell Vaccine or Dendritic Cell Therapy (DCT) is an antigen extracted from the cancerous tumor from which antibody is developed for the same from the patient’s blood. The antibody then recognizes and targets the foreign body cells. In addition, the existing cells are strengthened more to fight against the foreign body cells. After a period of maturation the foreign body cells are infused into the recipient. Since the vaccine is derived from the patient’s own blood, there is no adverse reaction reported. Each infusion requires 20 to 30 ml of the patient’s blood. In case of 6 infusions, 120 to 150 ml of the patient’s blood will be needed for the entire course. The contents are stored in a vial from where the antibody is taken.

Oncologist on DCT

Dendritic Cell Therapy (DCT) is available as DENVAX in India. DC therapy can be received after conventional therapy, that is, Radiation, Chemotherapy and Surgery. People are advised to complete the conventional treatment available for cancer, and then have DCT administered, to prevent relapse and reduce the progression of cancer cells. In case of high risk patients, i.e. people who face relapse, administering DENVAX definitely affords better results, says Dr. Sumana Prem Kumar. She further explains about getting DCT independently, “Though DENVAX can be given alone, the effectiveness is much better when in combination with chemotherapy, where it reduces the side effects of chemotherapy and helps fight against cancer cells. Given separately after conventional therapy is a better option. Finish the conventional therapy such as radiation and chemotherapy or surgery and chemotherapy or radiation and surgery and then take DC Vaccine.” A single infusion takes between half an hour to 1 hour to be transmitted. As for the side effects, at the most a patient may have fever for 24 to 48 hours.

Benefits of DCT:

• Quality of life improves. In extreme cases, patients facing cancer recurrence within 3 months can live longer by up to 9 months.
• Survival period is likely to be a disease free state.
• Progression of disease is retarded. If the patient who undergoes the conventional treatment still has the residue, the rate of the progression of the disease reduces with immunotherapy.
• No side effects because it is not a product manufactured externally. Blood and fluid derived from the patient is used in the patient’s body to make the foundation of the anti-body. Hence graft versus host reaction is absent.
• Prevents side effects such as vomiting and hair loss. Chemotherapy reduces the cells and frequent chemotherapy is tiresome because it kills cancer cells and normal cells. Then the cells have to recuperate. Till then a patient bears the side effects such as vomiting and hair loss. DCT prevents those side effects.
• Pain free butterfly infusion.

Ovarian Cancer Survivor Recounts

Mrs. Devi Srinivasa Raghavan, Ovarian Cancer Survivor, is the first in Chennai, Tamil Nadu, South India, to have had DCT. In 2010, Mrs. Raghavan was diagnosed with 4^th stage ovarian cancer with no hope to survive. Previously she had chemotherapy, resulting in side effects such as leg pain and constipation. After having removed her ovaries, uterus and part of her liver because of metastases, she lost her immunity and her WBC went extremely low. Left completely drained, her children and children–in-law suggested DCT. Breaking the process down, neutrophils were separated and multiplied from the blood drawn for analysis. The neutrophils cells were then directed to the dormant dendritic cells. The dormant cells now activated, attacked the cancer cells and warded them off. A recipient of totally 9 infusions administered thrice, had 20 to 30 ml of her blood drawn for each session. The vaccine stored in a vial was administered along with 100 ml of DNS and infused intravenously. The amount of transfusion also depends according to the patient’s weight. Since Mrs. Raghavan was only 40 kgs she was given 100 ml of the vaccine. She recalls feeling totally energetic, her wobbly walk stable, her blood count picking up, and her immunity getting better after DCT. “I felt only a pin prick and the best part was I experienced no pain and vomiting, which is such a blessing. Since I feel rejuvenated my hair has started to grow back.”

Dentritic Cell Therapy is available for all solid tumors, in breast, bone, brain, bladder, colon, head and neck, and pancreas. In other words it is available for any tumor in an organ except hematological malignancies, where it is not available as yet. The treatment has proven beneficial in lymphomas but not administered in leukemia. Also, as of now DCT is used in advance stages of cancer and not in the early stages. High risk patients benefit the most from immunotherapy. The practice of DCT is yet to catch up in many other places in India because practitioners are skeptical about stem cell therapy in general.

An Editorial Note from Medindia

Dendritic Cell therapy for cancer has invited many comments from readers. Our stand is as follows:

We will be inviting more discussion from original researchers on this topic and keep our readers updated about the progress made in the field. Cancer research continues to allure us and challenge us in various ways both in finding the cause and cure of the disease.

Medindia is a health network, looking to serve the people and impart as much knowledge on health topics to people as possible and this is done as impartially as possible. Medindia does not endorse the views and ideas expressed by the people or institutions featured in the articles.

About Dendritic Cell therapy

Dendritic cells are found in the blood stream and are a unique set of antigen-producing cells that are usually present in very small numbers whose main function is to identify foreign substances, including cancer cells and rectify them. Since dendritic cells are considered as the most potent antigen-producing cells, they have been used in cancer immuno-therapy to induce specific anti-tumor immunity to attack the tumor cells. The first attempt to use dendritic cells as cancer vaccines in humans was made by Edgar Engleman and Ronald Levy at the Stanford University. Acknowledging the above article, Medindia.net would like to clarify the following points based on the article and its contents.

• The Stanford University experts through treatments for various types cancers have confirmed the efficacy of the Dendritic Cell (DC) therapy
• The studies conducted by the Stanford experts reveal that DC therapy is a generally safe and promising form of immuno-therapy which can be applied to a wide range of malignancies
• DC therapy is documented as most effective against B cell lymphoma, myeloma, melanoma, prostate cancer, colon cancer, ovarian cancer, breast cancer and renal cell cancer amongst other types of cancer
• As mentioned in the article, the DC therapy has been approved by the U.S Food & Drug Administration recently (2010)
• According to the experts, the current DC therapy approach is far from optimal in that many patients treated with DC vaccines have failed to respond and only about 15 percent of the patients respond positively
• Dendritic Cell therapy can be considered when every other therapy option is exhausted, or if the disease is stable and the patient is not on any chemo or radiation therapies concurrently, or if the patient is at risk for recurrence of cancer and is seeking to potentially reduce the risk
• If the treatment is necessary, the patient should consult with a reputable and knowledgeable physician and seek professional advice on the cancer and DC therapy, thereby carefully weigh treatment options. Also, the treatment in itself is very expensive and the people are advised to stay away from fraudsters who may take advantage of the vulnerability of the patients by giving false hope

References

1. http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70585-0/abstract

2. http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/immunotherapy-cancer-vaccines

3. http://dendritic.info/

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4. http://cancer.stanford.edu/research/immunology/dendritic.html

Source-Medindia