Dendritic Cell therapy & Supporting Strategies

Update on April 2016: I do not see this option as a top option anymore given that I heard many actually starting to progress after starting this therapy. It is not only one person but several so a pattern starts to occur. Note that DC is typically given with New Castle Disease Virus – so I am not sure if NDV or DC leads to progression.

Dendritic cells (DC) therapy (in combination with anti PD1) is one of the most interesting cancer therapy in this world. DC vaccine alone costs about 4500 euro for one vaccine and is available at various clinics in Europe and US. One of the best clinic working with Dendritic cells is that of dr. Nesselhut in Germany (for contact details see clinics section). They have a relatively large research lab supported by the German government. They are also collaborating with dr. Raymond Chang in USA (New York) so that their treatment is accessible in US as well. (Here is an introduction from dr. Raymond Chang on DCs.). Dr. Nesselhut clinic claims great results with DC and even more when combining with New Castle Disease virus andwith low dose anti PD1 (e.g. Nivolumab).
RGCC is also offering DCs through the clinics they are working with. If you like to investigate what are the options you can contact RGCC and ask what are the clinics near you that may offer their DC vaccine.

dendriticDendritic cells: Monocytes are taken from the patient by means of leukapheresis (less desirable procedure for those with low immune system) or simple blood withdrawal, so that extra dendritic cells can be cultivated outside the body. Those dendritic cells are “educated” to recognize tumors (primed with tumor sample from patient or peptides and/or viruses such as New Castle) and returned to the patient. It is typically indicated to have multiple treatment of this type and it may be combined with theNew Castle Disease virus (NDV) administration. In this case NDV will be used to prime DCs. NDV is first introduced into the body and will end up localized in the tumors only, since the tumors do not have the capability to generate interferon and kill the virus. After some hours DC vaccine is administrated with the DCs previously primed to recognize NDV so that they will end up targeting thetumors. This is the technique used by dr. Nesselhut clinic. RGCCs technique for DC production is partially different than that ofdr. Nesselhut, i.e. RGCC may produce DCs by priming them with the circulating tumor cells (CTC) in the blood. This is relatively special technique that can not be done by many to my knowledge and RGCC is probably the best in this since they are very experienced at capturing the CTC (typically used for the chemo sensitivity tests). While I think RGCC can use tumor samples too for priming the DCs, with this technique there is no need for a tumor sample but only some blood sample.

Ref for fig. above http://www.dendriticcellresearch.com/denvax

Once we decided to go for DC treatments, here are a few additional supplements and drugs that can be considered to be used as a supportive strategy for the DC therapy:

Addressing (inhibiting) Tregs

  • Cimetidine 800mg/day (Ref)
  • Metformin 1000mg/day – 2000mg/day
  • Cyclophosphamide 50mg 3x/week (as used by Prof. dr. Dana Flavin)

Addressing tumor microenvironment – making tumor surrounding less acidic in order to support the T-cell function:

  • Lanzoprazole or Omeprazole, e.g. 40-80mg/day
  • Statins (MCT1 inhibition), e.g. Medastatin at 40mg/day
  • Resveratrolat 500mg/day
  • Other proton transport inhibitors such as Amiloride 15-30mg/day, Acetozolamide 200mg/day
  • 2DG would also leadto reduced proton output (1-2g/day)
  • DCA20mg/kg/day and Alpha Lipoic Acid600-900mg/day will lead to reduced acidity

Others:

References

Cancer immunotherapy via dendritic cells Cancer immunotherapy attempts to harness the power and specificity of the immune system to treat tumours. The molecular identification of human cancer-specific antigens has allowed the development of antigen-specific immunotherapy. In one approach, autologous antigen-specific T cells are expanded ex vivo and then re-infused into patients. Another approach is through vaccination; that is, the provision of an antigen together with an adjuvant to elicit therapeutic T cells in vivo. Owing to their properties, dendritic cells (DCs) are often called ‘nature’s adjuvants’ and thus have become the natural agents for antigen delivery. After four decades of research, it is now clear that DCs are at the centre of the immune system owing to their ability to control both immune tolerance and immunity. Thus, DCs are an essential target in efforts to generate therapeutic immunity against cancer.

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11 thoughts on “Dendritic Cell therapy & Supporting Strategies

  1. my partner has triple.negative breast cancer. she has been very ill recently after 4 treatments of various chemotherapy. and is too ill to receive trials at Christie hospital in Manchester where she had received bad new 13 weeks ago that she has 6-12 month to live. we don’t know which way to turn and would be grateful for some information from yourself…joanne Is currently in an hospice in aintree liverpool a mile from where we live…we had more bad news on Friday the 7oct that she will only have a minimum 6 months with us…so it was devastating news…we want some hope some some different opinion some optomism. os this possible..john nugent…joannes partner…

    1. Dear John,

      I am very sorry to hear that you have to go through this. I understand this very well as I am go through similar challenges.

      First, never lose hope and search always for positive reference points. There are many success stories next to the statistics.

      Second, you could contact Claire at https://www.triplenegative.co.uk/. She is TNBC patient as well, from UK, surviving for long time with the help of various new treatments. She may help with good advises.

      Third, ask your doctor if the tumor shows androgen receptors?
      It seems that a good part of TNBCs have that, and if that is the case they can respond very nicely to some (no-side-effects) drugs.
      Here is a reference on that:
      Complete Response of Metastatic Androgen Receptor–Positive Breast Cancer to Bicalutamide: Case Report and Review of the Literature http://jco.ascopubs.org/content/34/4/e21.full

      I hope this helps and please always keep your hope and positive expectation.

      Kind regards,
      Daniel

      1. Thank you Daniel, the tumor is a clear cell ovarian carcinoma. So high risk for recurrence and low response to chemo. We want to avoid the normal course of this tumor……

        1. Dear Alberto,

          You are very welcome. I actually know only one lady with melanoma who responded and was cured with DC. And melanoma is known to respond well to immuno therapies. But I also know many who did not responded and maybe even started progressing while on NDV+DC. This is a very expensive option and depending on the tumor location and size, for this money I would also consider TACE and Cryoablation.
          Besides this, we discussed on this website many other relevant options that can increase the chance of success. If there are questions on them please let me know.

          Kind regards,
          Daniel

          1. Daniel,
            my husband has stage 4 rectal cancer…we are looking at dendritic cell therapy in Germany. do you have any suggestions? There isn’t a whole lot of information online re: stats.
            K

            1. Hi Kris,

              Please let me know what are the other treatment options you are considering. If you have to make a choice, I can give you my opinion. (DC therapy is expensive and unless money are not an issue, is good to consider what else you could do with those money.) Regarding colon and colorectal cancer, you will be able to find some relevant treatments-related info on this website if you use the Search option on top-right of this page.

              Kind regards,
              Daniel

  2. thanks for getting back to me..he is doing the Gamma Delta T therapy and Lantolin. We are also looking to go to Germany for Dendritic Cell therapy. We will look at this website for additional treatments too. I have been unable to find any stats on the DC treatment in Germany though..Please pass on any information you have if any. Thanks

    1. thanks kris. I do not know Lantolin. Gamma Delta is indeed interesting. Regarding the DC therapy, I am not that sure … I do know a lady with melanoma who responded nicely to combo of DC+anti PD1 in low dose and was cured. But melanoma has high chance to respond to immunotheraphies. Another lady with triple negative is long term survival while her main treatments were constant TACE and DC. Not sure if DC was a reason for her survival. But I also know more people who did not experience benefits. Some even suggested a potential progression triggered by DC. Some clinics may promise a lot – make sure when you communicate with them you ask about statistics on survival improvement and cure rate – otherwise they might use misleading words such as “response rate”. I hope this helps a bit. Kind regards, Daniel

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