Dendritic cell vaccination as a treatment modality for mesothelioma

Evaluation of: Hegmans JP, Veltman JD, Lambers ME et al. Consolidative dendritic cell-based immunotherapy elicits cytotoxicity against malignant mesothelioma. Am. J. Respir. Crit. Care Med. DOI: 10.1164/rccm.200909-1465OC (2010) (Epub ahead of print).Malignant mesothelioma is caused by the neoplastic transformation of mesothelial cells and occurs predominantly in the pleura, but also less frequently in the peritoneum, pericardium or tunica vaginalis testis. Exposure to asbestos, a mineral fiber, is the major causative factor. Median survival is approximately 9 months from the onset of clinical symptoms. Median survival is only increased by about 2 months after treatment with currently validated chemotherapy, with the median time to progression also increased by 2 months. All other therapeutic strategies have shown no, or limited, survival benefit. Because of the limited success of conventional treatments, novel therapeutic regimens are being investigated, including immunotherapy. A new vaccine, developed as an adjuvant to chemotherapy in the treatment of malignant mesothelioma, was described in a recent issue of The American Journal of Respiratory and Critical Care Medicine. This vaccine has been proposed to induce the activation of an immune response against the cancer cells. A group from The Netherlands has demonstrated that this immunotherapy is able to favor an anti-tumor response, associated with objective clinical evidence.