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Oksana Skachkova



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    P2.04 - Immunooncology (Not CME Accredited Session) (ID 953)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.04-22 - Dendritic Cell Based Immunotherapy in Stage  IIB-IIIA  Non-Small Cell Lung Cancer Patients: 10-Years Experience.  (ID 14313)

      16:45 - 18:00  |  Author(s): Oksana Skachkova

      • Abstract
      • Slides

      Background

      Current immunotherapy options for non-small cell lung cancer (NSCLC) patients include tumor vaccines, cellular immunotherapies and immune checkpoint inhibition therapy, but which of them is most efficacious is unknown. Here, we represent a data of 10-years follow-up study of DC-vaccine immunotherapy effectiveness in stage IIB-IIIA NSCLC patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Two hundred fifty-three eligible patients with stage IIB-IIIA NSCLC were enrolled into the study. Patients were randomly allocated into two groups: 1 st – patients received DC based immunotherapy as adjuvant treatment option, 2nd - control group of patients who received surgery only. DC in amount 4,62±0,37x106 per injection were injected intravenously in 1-3 courses (6 months interval). One course consisted of 5 injections with one-month interval. Patients were monitored for immune function measures before and 1 month after each DC administration. Correlation between EGFR and KRAS mutation and clinical outcome was investigated.

      4c3880bb027f159e801041b1021e88e8 Result

      Log-rank test revealed that the DC based immunotherapy contributes to significant increase in 5- and 10-years overall survival (OS) and event free survival (EFS) of NSCLC patients. Thus, the 5-years OS rate was 44,4% vs. 30,4% and the 10-years OS rate – 30,3% vs. 13,8% in DC-immunotherapy and control groups respectively (p=0,009); HR=0,60; 95: CI = 0,43-0,85, For patients in DC- immunotherapy group, the 5-years EFS rate was 42,8 % in contrast to 23,5 % in patients of control group (p=0,0085). At 10-years follow-up, we could observe that the difference in EFS rates between two groups decreases, but remains statistically significant: 22,6 % vs 10,5 % (p=0,0032); HR=0,58; 95: CI = 0,42-0,80. DCs based immunotherapy is effective modulator of the immune system of NSCLC patients. After the 3rd DC administration, changes in the balance between Th1- and Th2- type of immune response have been occurred. Prognostic significance of immunological parameters ‒ TGF-β mRNA expression level, the number of CD4+CD45RO+ cells in circulation, the ratio of CD3 +IFN-γ+/CD3+IL-4+ after incubation with autologous tumor cells lysate has been revealed. According to proportional hazard Cox regression, EGFR and K-RAS mutations were not found to be associated with DC vaccine efficacy in NSCLC patients.

      8eea62084ca7e541d918e823422bd82e Conclusion

      DC based cellular immunotherapy enhanced 10-years OS and EFS in stage IIB-IIIA NSCLC patients. EGFR and KRAS mutation positivity was not predictive of survival benefit from DC based immunotherapy.

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