肝臓がん治療に細胞ベースワクチンを追加することで患者の癌進行を遅延(Adding cell-based vaccine to liver cancer therapy slows cancer progression in patients)

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2025-08-26 バーミンガム大学

バーミンガム大学主導の国際共同研究チームは、肝細胞がん(HCC)患者を対象に、腫瘍への化学塞栓療法(TACE)に樹状細胞ワクチンを併用する世界初の第II相臨床試験「ImmunoTACE」を実施した。48名を対象にしたランダム化比較試験の結果、無増悪生存期間は標準治療群の平均10か月に対し、併用群では18か月と大幅に延長された。このワクチンは患者自身の白血球から樹状細胞を培養し、がん抗原を取り込ませた後に体内へ戻すことで免疫応答を誘導する。副作用は比較的軽度で、治療は良好な忍容性を示した。研究責任者デイヴィッド・アダムズ教授は、本成果が肝がん治療における新たな選択肢になる可能性を示すと強調し、今後は免疫チェックポイント阻害薬との併用など追加研究が必要だと述べた。この成果は、進行が早く治療選択肢の限られた肝がんに対し、有望な免疫療法の道を開くものと評価されている。

<関連情報>

肝細胞癌患者におけるシクロホスファミド前処置と化学塞栓療法への樹状細胞ワクチン追加:ImmunoTACE試験 Addition of Dendritic Cell Vaccination to Conditioning Cyclophosphamide and Chemoembolization in Patients with Hepatocellular Carcinoma: The ImmunoTACE Trial

Yuk Ting Ma;Jianmin Zuo;Amanda Kirkham;Stuart Curbishley;Miroslava Blahova;Anna L. Rowe;Camilla Bathurst;Homoyoon Mehrzad;Salil Karkhanis;Pankaj Punia;Martin W. James;Nick Stern;Ankit Rao;Diana Hull;Faye Lowe;Panagiota Sylla;Luke Webster;Syed Hussain;Christina Yap;Daniel Palmer;David H. Adams
Clinical Cancer Research  Published:August 14 2025
DOI:https://doi.org/10.1158/1078-0432.CCR-25-0142

肝臓がん治療に細胞ベースワクチンを追加することで患者の癌進行を遅延(Adding cell-based vaccine to liver cancer therapy slows cancer progression in patients)

Abstract

Purpose:

A previous study by our group using dendritic cells (DC) pulsed ex vivo with the lysate of the HepG2 cell line showed evidence of antigen-specific T-cell responses in some patients with advanced hepatocellular carcinoma. The ImmunoTACE trial evaluated the preliminary activity of this vaccine in combination with transarterial chemoembolization (TACE) in patients with intermediate-stage hepatocellular carcinoma.

Patients and Methods:

A randomized phase II trial was conducted in three tertiary referral centers in the United Kingdom. Eligible patients were randomly assigned in a 1:1 ratio to TACE + preconditioning cyclophosphamide or to TACE + preconditioning cyclophosphamide + DC infusions. The primary endpoint was progression-free survival time using RECIST v1.1 criteria. Additional endpoints included safety and immune responses.

Results:

Between March 2016 and October 2019, 55 patients were randomized, of whom 48 were evaluable (24 in each group). The median progression-free survival time using RECIST criteria was 18.6 months in patients treated with chemoembolization + preconditioning cyclophosphamide + DC infusions compared with 10.4 months in those treated with chemoembolization + preconditioning cyclophosphamide alone (HR = 0.43; upper value of one-sided 80% confidence interval, 0.57; P = 0.016). The addition of DC infusions did not significantly increase the incidence or severity of adverse events. An enhanced antigen (α-fetoprotein)-specific immune response was observed in patients treated with DC vaccination.

Conclusions:

The addition of DC infusions to TACE and preconditioning cyclophosphamide has shown promising preliminary activity and merits further investigation in a larger randomized trial.

医療・健康
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