The use of dendritic cells for cancer vaccination.

Dendritic cells (DC) are the most potent antigen presenting cells (APC) and the only ones capable of presenting novel antigens to naïve T-cells. Large numbers of DC can be generated in vitro in the presence of appropriate cytokine cocktails using either adherent peripheral blood mononuclear cells (PBMC) or CD34+ precursors. More than 20 preclinical studies have demonstrated the effectiveness of antigen-loaded DC to mediate antitumor immune responses. Three clinical trials have been reported to date that show DC as a promising tool for the immunotherapy of cancer. However, completion and analysis of randomized trials to establish the appropriate antigen(s), adjuvant(s), dose, route and schedule will be crucial. Future DC-based therapies will include genetic modification of DC, the use of CD34+ precursors, direct delivery of DC to tumors, and application of tumor lysates or apoptotic cells as sources of additional, as yet undefined, antigens.