Immunocompetent for immunotherapy? A study of the immunocompetence of cervical cancer patients

Abstract

Sixty-five patients with cervical carcinoma and 17 control subjects were studied to determine immunocompetence as a prerequisite for immunotherapy using live virus vectors. T-cell immunity, measured by surface phenotype and proliferative assays, was reduced with increasing volume of invasive disease, and independent of treatment effects. Both the CD4+ and CD8+ subsets were affected so that the CD4:8 ratio remained within normal limits. In contrast B-cell number, immunoglobulins and complement were normal as were in vivo responses to a polysaccharide vaccine. Thus, determination of immunocompetence prior to use of live vector immunotherapy requires assessment of each individual subject, especially in those with advanced disease.

Peripheral blood lymphocyte subpopulations in patients with cervical cancer

“…This may be the possible reason for the CD4+/CD8+ ratio of CA CX patients not being significantly different as compared to the control group. This result is in good agreement with the work of Fiander et al [19] who have reported that the CD4+/CD8+ ratio does not change in CA CX patients as both the populations are affected [19]. There are, however, previous reports that have shown a reduction in CD4+/CD8+ ratio in PBL of CA CX patients [8–10].…”

Human Papillomavirus Type 16 and 18 E7-Pulsed Dendritic Cell Vaccination of Stage IB or IIA Cervical Cancer Patients: a Phase I Escalating-Dose Trial

“…Unfortunately, however, the majority of patients with advanced cervical cancer have been heavily pretreated with radiation and/or multiple regimens of palliative chemotherapy and are often profoundly immunocompromised at the time of vaccination treatment (11,19,21). Here, we describe the results of the first clinical trial using recombinant full-length HPV16/18 E7-pulsed autologous DC vaccination as an adjuvant therapy for patients harboring early-stage cervical cancer.…”

Phase II trial of cetuximab in the treatment of persistent or recurrent squamous or non-squamous cell carcinoma of the cervix: A Gynecologic Oncology Group study

“…The efficacy of the anti-EGFR antibody (M225) when used as an F(ab) 2 in blocking the growth of tumors in vivo has been previously demonstrated to be only 50% of the activity shown by the intact antibody when it is able to engage the Fc receptors on NK cells [53]. These findings suggest that host factors related to a low number and/or lack of killing activity of effector cells (i.e., NK cells), as previously reported by multiple groups studying the immune-competence of cervical cancer patients heavily pretreated with radiation and chemotherapy, may present a major barrier to the successful clinical development of therapeutic biologic reagents (i.e., IgG 1 mAb such as cetuximab) in end-stage cervical cancer patients [56–58]. Prospective evaluation of the immune-competence of such patients therefore seems to be warranted in future studies.…”