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Complete remission following decitabine/dendritic cell vaccine for relapsed neuroblastoma.

Abstract
Patients with relapsed stage 4 neuroblastoma have an extremely poor long-term prognosis, making the investigation of new agents of interest. We report the outcome of the first patient treated in a phase 1 study for relapsed neuroblastoma, using the chemotherapy agent decitabine to upregulate cancer testis antigen expression, followed by a dendritic cell vaccine targeting the cancer testis antigens MAGE-A1, MAGE-A3, and NY-ESO-1. Our patient had persistent tumor in his bone marrow after completion of standard therapy for neuroblastoma, including multiagent chemotherapy, tumor resection, stem cell transplantation, radiation therapy, and anti-GD2 monoclonal antibodies. His marrow disease persisted despite chemotherapy, which was given while the vaccine was being produced. After 3 cycles of decitabine and vaccine, this patient achieved a complete remission and is now 1 year from his last treatment, with no evidence of tumor in his bone marrow or other sites. This patient was noted to have an increase in MAGE-A3-specific T cells. This is the first report combining demethylating chemotherapy to enhance tumor antigen expression followed by a cancer antigen vaccine.
AuthorsDeepa Kolaseri Krishnadas, Teresa Shapiro, Kenneth Lucas
JournalPediatrics (Pediatrics) Vol. 131 Issue 1 Pg. e336-41 (Jan 2013) ISSN: 1098-4275 [Electronic] United States
PMID23266925 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Cancer Vaccines
  • decitabine
  • Azacitidine
Topics
  • Azacitidine (administration & dosage, analogs & derivatives)
  • Cancer Vaccines (administration & dosage, immunology)
  • Child
  • Dendritic Cells (transplantation)
  • Hematopoietic Stem Cell Transplantation (trends)
  • Humans
  • Male
  • Neuroblastoma (diagnosis, immunology, prevention & control)
  • Recurrence
  • Remission Induction (methods)

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