Endotoxemia in immunotherapy with dendritic cell vaccine in patients with advanced cervical cancer

Abstract

Purpose of the study. Assessment of albumin and endogenous intoxication levels in patients with locally advanced cervical cancer receiving immunotherapy with dendritic cell vaccine.Materials and methods. The study included 27 patients with advanced cervical cancer (CC) divided into 3 groups: 1) patients receiving dendritic cell vaccine (DCV) during primary chemoradiation treatment; 2) patients with the disease progression receiving DCV during second‑line chemotherapy; 3) patients with advanced disease with contraindications for chemo‑radiation treatment receiving DCV only. The comparison group included 20 healthy women. All groups were tested for levels of medium‑weight molecules (MWM254 and MWM280), total and effective concentrations of albumin (TCA and ECA), toxicity index (TI) characterizing the sorption capacity of albumin, and the coefficient of intoxication (CI) reflecting the balance between the accumulation and binding of toxic ligands.Results. Initial elevation of MWM was observed in all patients. Levels of MWM254 were the highest in patients with progression. TI in patients with primary and progressive CC was increased before the treatment by 1.7 and 2.2 times, and after CT (without DCV) – by 2.6 and 3.8 times. In group 3, TI was increased by 4 times, and CI by 2.5 times, being 81 % higher than in group 1. In primary patients, TI after 6 and 7 DCVs was similar to the normal values, and CI was increased during the treatment because of the accumulation of MWM254 due to disintegration of tumor masses in these patients, and then it was normalized after 7 DCVs. CI in patients of groups 2 and 3 decreased after each DCV session. 4 and more DCVs restored the functional activity of albumin and normalized the MWM content.Conclusion. Administration of DCV (at least 7–8 sessions) in CC patients receiving anticancer treatment or as monotherapy decreases endotoxicosis and restores detoxification capacity of albumin.