A new study has shown that patients with intermediate stage primary liver cancer had longer periods of progression-free survival, meaning their disease did not grow or spread, after receiving a vaccine made from their own immune cells.

The ImmunoTACE trial, the first clinical trial of its kind, tested this approach in patients with hepatocellular carcinoma (HCC), the most common form of primary liver cancer, with approximately 3,600 new cases diagnosed annually in the UK.

The vaccine was given alongside standard treatment, which includes tumour chemoembolization, a procedure that blocks the blood vessels feeding the tumour, and chemotherapy.

The trial was a collaboration between the University Hospitals Birmingham NHS Foundation Trust (UHB), University of Birmingham, Nottingham University Hospitals NHS Trust and Aintree University Hospital and Clatterbridge, funded by the National Institute for Health and Care Research.

48 patients were recruited to receive either standard treatment alone or standard treatment alongside the cell-based vaccine.

The vaccine is made from dendritic cells, a special type of immune cell that helps coordinate the body’s response to diseases, including cancer, by activating immune killer cells to recognise and destroy cancer cells.

The dendritic cells used in the study were expanded from the patients’ own white blood cells by growing them in a purpose-built laboratory for eight days, with proteins taken from cancer cells. The cells allow the immune system to see these proteins and then to mount an immune attack on the cancer cells that bear them.

While dendritic cells are produced naturally in the body, studies have shown that in patients with cancer they can become “exhausted” and stuck within the tumour, rather than carrying cellular information back to the lymph nodes where they can activate immune killer cells.

The idea of dendritic cell vaccine is to restore and uncover immune responses to the cancer. The current trial design reports that this therapy can be both affordable and effective. 

Patients received the cell-based vaccine at the same time as standard treatment with chemo-embolization, and then monthly for a further three months.

In the experimental arm of the trial, the average time to tumour progression was 18 months, compared with just 10 months in the group receiving standard treatment alone.

Dr Yuk Ting Ma, lead author of the study and Honorary Consultant in Hepatobiliary Oncology at UHB, said: “These are very promising findings that demonstrate the potential use of dendritic cell vaccines in a widely prevalent and hard to treat cancer. With our approach to developing the vaccine, focusing on stimulation with multiple tumour antigens, we have shown a strong signal that we believe warrants testing in larger trials in patients with liver cancer.”

Matthew Metcalfe, Hospital Executive Director at Queen Elizabeth Hospital Birmingham (QEHB), part of UHB, said: “This trial is a powerful example of Birmingham Health Partners in action with clinicians and researchers from UHB and University of Birmingham working to explore innovative treatments to transform outcomes for patients with liver cancer. Our collaboration reflects the strength of Birmingham’s research community, and we are proud at QEHB to be leading studies with the potential to make a real difference to patients and their families.”