Congress Abstracts 2004

87

TUMOR-SPECIFIC DENDRITIC CELL VACCINES: INNOVATIVE THERAPY FOR PRIMARY AND METASTATIC BRAIN TUMORS. Kara Penne, RN, BSN, OCN^®, and Cindy Bohlin, RN, MSN, Duke University Medical Center, Durham, NC; Alison Paolino, RN, MSN, Emory University, Atlanta, GA; and John Sampson, MD, and Gary Archer, PhD, Duke University Medical Center, Durham, NC.

Historically, malignant brain tumors are resistant to many conventional therapies including chemotherapy and radiation, thus contributing to the poor prognosis for these patients. Median survival for newly diagnosed WHO Grade IV glioblastoma multiforme (GBM) after radiation therapy alone is 40 weeks (Medical Research Council Brain Tumor Working Party, 2001). Dendritic cell vaccines can play a significant role in the treatment of these types of tumors. Dendritic cell vaccine therapy is a new and innovative method of fighting cancer by strengthening the immune system.

Dendritic cell vaccines mobilize and strengthen the patient’s own immune system against their tumor cells. Most malignant gliomas express EGFRvIII, a mutated protein sequence that is not found in any normal adult tissues, which makes it an ideal target for tumor-specific vaccines. The purpose of this poster is to describe the mechanism of action of dendritic cell vaccine therapy, provide preliminary results, and discuss nursing implications of a phase I clinical trial that is evaluating the effectiveness and associated toxicities of a tumor specific dendritic cell vaccine for the treatment of primary brain tumors.

In this clinical trial, 14 patients newly diagnosed with high-grade gliomas (glioblastoma multiforme (GBM), n = 12; anaplastic astrocytoma (AA), n = 1; anaplastic oligodendroglioma (AO), n = 1) were treated with dendritic cell vaccine therapy. The vaccines were administered every 2 weeks for 6 weeks (total of 3 vaccines). Following the vaccine, patients undergo dermatologic testing and biopsies at least every 3 months to evaluate immune response to the vaccine.

Potential side effects include fever, chills, headache, allergic reaction, and autoimmunity. Results to date show no clinical progression in 5 patients and disease progression in 9 patients. Median survival since diagnosis is 45 weeks for GBM, 63 weeks for AA, and 317 weeks for AO.

Oncology nurses must be aware of the action mechanism and possible toxicities associated with vaccine therapy in order to provide patients with appropriate care and education. Updated results of this ongoing clinical trial will be presented. Nursing implications for the assessment and management of patients receiving dendritic cell vaccine therapy will be discussed.