Original articleThe efficacy of dendritic cell vaccine for newly diagnosed glioblastoma: A meta-analysis of randomized controlled studies
Introduction
Glioblastoma is the most common malignant primary brain tumor. Although the development of maximal safe surgical resection and radiotherapy with concurrent chemotherapy, glioblastoma is still associated with poor prognosis [1], [2], [3]. Five-year survival rate remained at 9.8% with standard of care treatment [4], [5]. The 2-year survival of glioblastoma was documented to be 26–33% after the treatment with radiotherapy and concomitant adjuvant temozolomide [6], [7].
Molecularly defined glioblastoma subtypes were associated with the expression of certain tumor antigens [8]. Suppression of B7-H4 resulted in T-cell activation and tumor regression in glioma xenografts [9]. The status of methylated O-6-methylguanine-DNA methyltransferase (MGMT) promoter also affected the prognosis. For instance, the survival rate was 12.5% at the follow-up of 4 years in patients with unmethylated MGMT promoters, while it is 45% for methylated MGMT promoter [10], [11]. Immunotherapies may have some special ability to treat various cancers such as hematological diseases, malignant melanoma, and renal carcinoma [12], [13], [14]. Dendritic cells can enhance immune reactions due to the antigen-presenting property [15].
Several studies explored the efficacy of dendritic cell-based therapeutic vaccines for glioblastoma, and demonstrated some potential of dendritic cell vaccines in treating glioblastoma [16], [17], [18]. However, several trials showed some conflicting results regarding the efficacy of dendritic cell vaccine for glioblastoma [19], [20], [21]. This meta-analysis of RCTs aimed to evaluate the efficacy and safety of dendritic cell vaccine to treat glioblastoma.
Section snippets
Materials and methods
This meta-analysis was conducted based on the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement and Cochrane Handbook for Systematic Reviews of Interventions [22], [23], and no ethical approval and patient consent were needed because all analyses were based on previous published studies.
Literature search, study characteristics and quality assessment
Fig. 1 showed the detail flowchart of the search and selection results. Two hundred and eighty-four potentially relevant articles were identified initially. Eighty-nine duplicates and one hundred and eighty-nine papers after checking the titles/abstracts were excluded. Two studies were removed because of the study design and four RCTs were ultimately included in the meta-analysis [19], [20], [21], [27].
The baseline characteristics of four included RCTs were shown in Table 1. These studies were
Discussion
Dentritic cells showed a potent immune stimulatory mode of action after the stimulus of pathogen-associated microbial pattern molecules [28], [29]. Interleukin (IL)-12-secreting dentritic cells could trigger robust helper T-lymphocyte type 1 and cytotoxic T-lymphocyte dominated immune responses [30], [31], [32], [33]. The immunostimulatory capability of dentritic cells may show some ability to treat cancers because of immunosuppressive features [32], [34], [35]. The early-stage clinical trial
Conclusion
Dendritic cell vaccine may had no benefits to treat glioblastoma.
Human and animal rights
The authors declare that the work described has not involved experimentation on humans or animals.
Informed consent and patient details
The authors declare that the work described does not involve patients or volunteers.
Disclosure of interest
The authors declare that they have no competing interest.
Funding
This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author contributions
All authors attest that they meet the current International Committee of Medical Journal Editors (ICMJE) criteria for Authorship.
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2022, International ImmunopharmacologyCitation Excerpt :Although many DC vaccines have attempted to improve the miserable survival rates of patients with GBM, phase III trials have not met the primary endpoint because of the inherent challenges of DC vaccines as well as the lack of rigorous inclusion criteria in randomized controlled studies. Some meta-analyses have even questioned that DC vaccines do not improve the survival time of newly diagnosed patients with GBM [73,74]. Therefore, it is necessary to discuss the challenges of developing DC vaccines for clinical products.
Research progress on dendritic cell vaccines in cancer immunotherapy
2022, Experimental Hematology and Oncology
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Z. Liu and C.Gao contribute equally.