Tumor Vaccination - Dendritic Cell Therapy

What is Dendritic Cell Therapy?

Dendritic cell therapy is a cancer treatment and is considered a cancer vaccination. The patient's immune system cells are taken from the blood and strengthened in the laboratory in this process. These cells and "trained" against the tumor to be treated. After the modified cells are returned, they can better recognize and fight the tumor as vermin. Since the patient's cells are used, there is no defense reaction as a side effect. In general, the side effects of this treatment are mild compared to other therapies in oncology. Therefore, dendritic cell therapy can be performed in outpatient settings without hospitalization. However, the effect of this therapy may be short-lived and may require multiple sessions.

How Does Dendritic Cell Therapy Work?

Dendritic cells are immune system cells and form a dense network of "sentinel cells" in almost all body tissues. They patrol the body's tissues to detect foreign structures and abnormally degenerated cells such as tumor cells. First, they take up proteins from outside the cells, from the so-called extracellular space. They then break down these proteins into smaller protein fragments and bind these to specific carrier proteins (known as MHC molecules). The MHC molecule with a protein fragment also called an antigen, is then transported to the cell surface and presented to another cell group of the immune system, the T-lymphocytes.

T-lymphocytes are the police of the immune system. They check each cell for self-produced proteins and check dendritic cells for proteins taken up from extracellular sources. When abnormalities occur, T-lymphocytes can kill the suspicious cells and activate other immune system cells, called B-cells. These are stimulated to produce specific antibodies against the presented protein fragments.

Tumor cells express specific proteins that can be recognized as antigens by T-lymphocytes. However, this usually does not sufficiently get the immune system going. On the one hand, this is because tumor-associated antigens also occur in small quantities in healthy tissue. On the other hand, tumor cells have many strategies to camouflage themselves from the immune system. Dendritic cells are therefore specialized antigen-presenting cells and can be used to generate immune responses against specific proteins of tumor cells and thus fight tumors with the patient's immune system.

To obtain a tumor vaccine, dendritic cells are extracted from the blood of tumor patients. In the laboratory, the dendritic cells obtained are loaded with the patient's tumor material and thus specifically trained against these proteins. Subsequent vaccination with the treated dendritic cells can lower the immune system's initial tolerance to the tumor. As a result, the tumor cells can no longer evade the immune system and are destroyed by T lymphocytes and other immune cells.

For Which Cancers Is Tumor Vaccination Used?

Dendritic cell therapy is considered an adjunct to standard treatments in oncology. Dendritic cell therapy is suitable as support to traditional therapies, e.g., chemotherapy and radiation therapy, because the immune cells can destroy damaged tumor cells better than intact tumor cells.

However, in small or inoperable tumors, this treatment can also be used as primary therapy. In 2010, immunotherapy using the patient's dendritic cells was approved for the first time to treat hormone-refractory prostate cancer in the USA (Sipuleucel-T).

Costs: Who Pays for Tumor Vaccination?

Currently, there is no general answer to this question. Statutory health insurances (SHI) are only obliged to pay for medically necessary treatments. This includes all treatment methods that cure, alleviate or counteract the aggravation of the disease. Currently, the SHI reimburses dendritic cell therapy in individual cases only if no other proven procedures and treatments are available. Although a few private health insurances cover the therapy costs, the obligation to pay has been established by the court in individual cases.

Which Medical Professionals and Clinics Are Specialized in Dendritic Cell Therapy?

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively and a reliable doctor would never claim to be the best one, we can only rely on a doctor's experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in tumor vaccination and are awaiting your inquiry or request for treatment.

Sources:

Schnurr, Maximilian et al.: Dendritische Zellen-Träger tumorgerichteter Immuntherapie, Deutsches Ärzteblatt (2002), 99(37): A-2408 / B-2058 / C-1929

Unbekannt: Aus Forschung wird Impfung, Jahresbericht des Uni-Klinikums Erlangen (2011),http://www.uk-erlangen.de/universitaetsmedizin/highlights-aus-dem-uni-klinikum/dendritische-zellen/?tx_form4contentpagination_pagination%5Bpage%5D=4&cHash=c34e9c677b845733736e3e55c13ff309, aufgerufen am 04.10.2017

F.Gansauge et al.: Effectivity of Long Antigen Exposition Dendritic Cell Therapy (LANEX-DC) in the Palliative Treatment of Pancreatic Cancer, Current Medicinal Chemistry (2013), Vol.20, No.38, 4827-4835

Palucka, Karolina et al.: Harnessing Dendritic Cells to Generate Cancer Vaccines, Ann NY Academic Science (2009), 1174: 88–98. doi:10.1111/j.1749-6632.2009.05000.x.