Nekhaeva, T. L., Savchenko, P. A., Novik, A. V., Efremova, N. A., & Baldueva, I. A. (2025). Assessment of Prognostic Value of Delayed-Type Hypersensitivity (DTH) Reaction in The Application of Autologous Dendritic Cell Vaccine in Patients with Melanoma and Soft Tissue Sarcomas. Voprosy Onkologii, 70(6), 1077–1085. https://doi.org/10.37469/0507-3758-2024-70-6-1077-1085

Abstract

Introduction. Dendritic cell vaccine (DCV) therapy is a promising immunotherapeutic approach for the treatment of malignant tumors. Estimation of delayed-type hypersensitivity (DTH) reaction is the useful method to determine the immunological efficacy of DCV application.

Aim. Evaluation of the prognostic value of DTH response in patients with melanoma (Mel) and soft tissue sarcoma (STS) receiving autologous antitumor DCV.

Materials and Methods. The study sample included 277 patients with morphologically verified diagnosis of Mel (n = 143), STS (n = 134), receiving DCV at the N.N. Petrov National Medical Research Centre of Oncology from 2009 to 2023 in adjuvant (78.3 % и 14.9 %) and therapeutic (21.7 % и 85.1 %) regimens for Mel and STS, respectively. Adjuvant therapy was performed in stage II-IV patients with a high risk of recurrence after complete cytoreduction. Therapeutic vaccine therapy was only used in patients who had exhausted their standard treatment options and had tumor foci. DCV was injected intradermally paravertebrally every 2-4 weeks at a total dose of at least 9-10 million cells. The DTH response was assessed 24 hours after each DCV injection by measuring papule size and hyperemia at the injection sites. The increase in DTH response ≥ 10 mm on treatment was considered a conversion of the DTH response. Multivariate Cox regression analysis was used to statistically evaluate DTH response parameters and their association with overall survival (OS) and time to progression (TTP).

Results. The conversion of the DTH response is a factor independent of other parameters (diagnosis, therapy regimen). In a multivariate model, the presence of DTH response conversion reduced the risk of death by 46 % (95 % CI 21-64 %; p = 0.02) and the risk of progression by 39 % (95 % CI 20-55 %; p = 0.001). The presence of conversion did not have strong (> 0.7) correlations of the regression residuals, confirming the independence of the variable.

Conclusion. Assessment of the DTH response to DCV injection is an important indicator to be determined during the course of treatment. Conversion of the DTH response is associated with an increase in TTP and OS and should be considered as an efficacy objective in patients with Mel and STS receiving autologous DCV.

https://doi.org/10.37469/0507-3758-2024-70-6-1077-1085

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