Taming the Metastatic Beast
A voracious, aggressive, and ruthless beast engulfs and commandeers the body of thousands of women every day, slowly deteriorating them. Ovarian cancer (OC), the brutish force, kills 15,500 women annually in America. Many women undergo chemotherapy, only to undergo a recurrence later on, thereby necessitating the scramble for an alternative treatment. A recent possibility, dendritic-cell (DC) based immunotherapy, induces an immune response with OC-specific immune cell markers. A team of researchers in Japan published “The feasibility and clinical effects of dendritic cell-based immunotherapy synthesized peptides for recurrent ovarian cancer patients.” Determining the efficacy of this treatment provides answers for uncertain treatment methods.
While DC immunotherapy is frequently studied, the scientists focused on a particular population of recurrent ovarian cancer (ROC) patients and analyzed the efficacy and feasibility of treatment. This could potentially explain how specific antigen proteins will respond to the therapy.
The researchers screened and selected 56 inoperable ROC patients who had undergone chemotherapy unsuccessfully. Antigen proteins, WT1, MUC1, and CA125 are crucial ROC markers and were assessed in each patient to tailor the respective specialized DC treatments. Patients were injected with the treatment five to seven times every 14 to 21 days. Immune cells such as CD4+ T cells, CD8+ T cells, WT1, and natural killer (NK) cells were quantified. Additionally, clinical assessments and observations of adverse events (AEs) were also monitored.
Efficacy was determined by measuring patient response. Patient conditions were classified according to the Response Evaluation Criteria in Solid Tumors. Three statistical tests were used: Kaplan-Meier probability estimates determined the survival probability and statistically significant data in the variables between treatment groups, the Cox regression method analyzed the effect of certain risk factors on survival, and the Fischer exact probability test determined whether differences between two variables were random.
DC-based immunotherapy was accepted in patients and induced an immune response. However, there was no correlation between the antigen-specific lymphocytes and mean survival time (MST). Further research includes using more OC-specific antigens to promote effective treatment.
The potential therapeutic effects of DC-based immunotherapy expand the breadth of cancer treatment. The study is rationalized with pertinent background info and the underlying flaws in past research. An extensive analysis is made of several variables such as antigen response and toxicity, which are well- grounded standards to determine potency of treatment. The researchers also address improvements for further studies such as a larger sample size.
However, there were discrepancies in the study’s protocol. Too many variables were manipulated such as antigen products each patient received and their historical diagnoses. Changing one variable would have reduced the complexity and factors being analyzed. Varying individual antigen treatments also provided flawed conclusive evidence on the correlation between antigen and treatment. The study was conducted in Japan, so the lack of diversity of the participants is a possible source of bias as variation of disease progression could be sourced to demographic variables like race. Furthermore, the medical research did not clearly indicate the use of a blind test.
The study focuses on an area of research that would be extremely valuable to women worldwide battling OC. By successfully investigating its efficacy and feasibility, the researchers find more information that will drive further research to manipulate the treatment, potentially to a final win.
Literature Cited
Kobayashi M, Chiba A, Izawa H, Yanagida E, Okamoto M, Shimodaira S, Yonemitsu Y,
Shibamoto Y, Suzuki N, Nagaya M. The feasibility and clinical effects of dendritic cell-based immunotherapy targeting synthesized peptides for recurrent ovarian cancer. J Ovarian Research. 2014;1-9.
