Reviewed and edited by: Dr. William Sibuor, M.D. (BSc. Anat (Hons), MBChB)
Malignant mesothelioma is an aggressive cancer with a poor prognosis. There aren’t many options to treat it. But there’s a secret weapon that can fight this cancer – and it’s already in your immune system.
Immunotherapy is about using the power of your immune system to fight diseases. A type of immunotherapy called dendritic cell-based immunotherapy may work to treat mesothelioma and help people live longer.
What is dendritic cell-based immunotherapy?
Dendritic cell-based immunotherapy is a way of treating diseases like cancer. The treatment makes use of special cells called dendritic cells. You already have dendritic cells in your body, and they’re basically your body’s police officers who go around catching bad guys and presenting them to courts of law to be charged for their offences.
Here’s how it works: Dendritic cells constantly move through your bloodstream looking for foreign antigens. A foreign antigen is a molecule of something harmful, like cancer, invading your body. Antigens trigger your immune system to fight back. Dendritic cells look for antigens and present them to your body’s T-cells so the T-cells can destroy the harmful substance (Gardner et al, 2020).
Cancer tumors are full of antigens, and your immune system is ready to fight back. But what if there aren’t enough dendritic cells to find the antigens and present them to your T-cells? The T-cells won’t be able to respond to the antigens and stop the cancer tumor.
That’s where dendritic cell-based immunotherapy comes into play.
How does dendritic cell-based immunotherapy work?
Mesothelioma tumors are like hard drug dealers causing trouble in a town. The police need to find these drug dealers, arrest them, and present them to a court of law where they can be punished. If the police don’t stop the drug gangs, the gangs will overrun the town.
In the same way, your dendritic cells need to find and “arrest” the antigens from the mesothelioma tumor, then present them to the T-cells that can get rid of them. But if there aren’t enough dendritic cells, the cancer will spread.
Let’s say the town starts a new program to train police officers to find and identify drug dealers fast. There’s just a small group of officers at first, not enough to solve the drug dealer problem. But then those officers train more officers, and soon there’s a large group of officers with special training to find drug dealers. Now the town can get drug dealers off the streets in large numbers.
This is exactly how dendritic cell-based immunotherapy works. First, doctors take some dendritic cells out of your body and expose them to antigens from the cancer tumor. This teaches the dendritic cells how to find cancer cells fast. Then these dendritic cells are cloned, so there are now a lot of dendritic cells that know how to find cancer cells fast.
The last step is putting these dendritic cells back into your body. This large squad of dendritic cells is a powerful force for finding cancer antigens and presenting them to the T cells. Then the T cells do their job and destroy the cancer cells (Salah et al, 2021).
What are the results of dendritic cell-based immunotherapy on mesothelioma?
Advanced clinical trials are in progress right now so scientists can find out how well dendritic cell-based immunotherapy works against mesothelioma.
A combined phase II/III study showed that when people with malignant pleural mesothelioma were given dendritic cell-based immunotherapy, the median survival rate was a promising 27 months (Dumoulin et al, 2021). In another study, when people with malignant pleural mesothelioma were treated with dendritic cells, they had more effector T-cells in their bloodstreams (de Goeje et al, 2018).
These studies look good, but more research is needed. Dendritic cell-based immunotherapy seems to work against mesothelioma, but the treatment may not be effective for everyone.
Dendritic cell-based immunotherapy side effects
The most common side effects of dendritic cell-based immunotherapy are flu-like symptoms like fevers and chills, and a reaction at the injection site. Fortunately, these symptoms aren’t that hard to treat.
In rare cases, dendritic cell-based immunotherapy can cause a life-threatening allergic reaction (anaphylaxis), liver damage, or lung damage. If you have any side effects, tell your healthcare provider as soon as possible.
Dendritic cell-based immunotherapy seems to be effective against mesothelioma. You already have dendritic cells that play a role in fighting cancer, and immunotherapy creates more of these cells. This treatment isn’t perfect and may not work for everyone. But scientists are studying how to make it work better so people with mesothelioma can live longer.
- Gardner A, de Mingo Pulido Á, Ruffell B. Dendritic Cells and Their Role in Immunotherapy. Front Immunol. 2020;11:924.
- Salah A, Wang H, Li Y, et al. Insights Into Dendritic Cells in Cancer Immunotherapy: From Bench to Clinical Applications. Front Cell Dev Biol. 202; 9:686544.39.
- Dumoulin D, Cornelissen R, Bezemer K, et al. Long-Term Follow-Up of Mesothelioma Patients Treated with Dendritic Cell Therapy in Three Phase I/II Trials. Vaccines (Basel). 2021; 9(5):525.
- de Goeje P, Klaver Y, Kaijen-Lambers M, et al. Autologous Dendritic Cell Therapy in Mesothelioma Patients Enhances Frequencies of Peripheral CD4 T Cells Expressing HLA-DR, PD-1, or ICOS. Front Immunol. 2018; 9:2034.