Safety and efficacy of autologous cell vaccines in solid tumors: a systematic review and meta-analysis of randomized control trials

Donald J Bastin; Joshua Montroy; Michael A Kennedy; Andre B Martel; Risa Shorr; Maryam Ghiasi; Dominique M Boucher; Boaz Wong; Louise Gresham; Jean-Simon Diallo; Dean A Fergusson; Manoj M Lalu; Natasha Kekre; Rebecca C Auer

doi:10.1038/s41598-023-29630-9

Safety and efficacy of autologous cell vaccines in solid tumors: a systematic review and meta-analysis of randomized control trials

Sci Rep. 2023 Feb 27;13(1):3347. doi: 10.1038/s41598-023-29630-9.

Authors

Donald J Bastin^{1

2}, Joshua Montroy³, Michael A Kennedy¹, Andre B Martel^{1

4

5

6}, Risa Shorr⁷, Maryam Ghiasi³, Dominique M Boucher^{1

5

6}, Boaz Wong^{1

5

6}, Louise Gresham⁴, Jean-Simon Diallo^{1

5

6}, Dean A Fergusson^{3

5

8}, Manoj M Lalu^{3

5

9

10}, Natasha Kekre^{1

5}, Rebecca C Auer^{11

12

13

14}

Affiliations

¹ Cancer Therapeutics Program, The Ottawa Hospital Research Institute, General Campus, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
² Schulich School of Medicine, Western University, London, ON, Canada.
³ Clinical Epidemiology Program, Blueprint Translational Research Group, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁴ Department of Surgery, University of Ottawa, Ottawa, ON, Canada.
⁵ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁶ Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada.
⁷ Learning Services, The Ottawa Hospital, Ottawa, ON, Canada.
⁸ School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
⁹ Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
¹⁰ Regenerative Medicine Program, The Ottawa Health Research Institute, Ottawa, ON, Canada.
¹¹ Cancer Therapeutics Program, The Ottawa Hospital Research Institute, General Campus, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. rauer@ohri.ca.
¹² Department of Surgery, University of Ottawa, Ottawa, ON, Canada. rauer@ohri.ca.
¹³ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. rauer@ohri.ca.
¹⁴ Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada. rauer@ohri.ca.

Abstract

We conducted a systematic review and meta-analysis of randomized control trials to formally assess the safety and efficacy of autologous whole cell vaccines as immunotherapies for solid tumors. Our primary safety outcome was number, and grade of adverse events. Our primary efficacy outcome was clinical responses. Secondary outcomes included survival metrics and correlative immune assays. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for studies published between 1946 and August 2020 using any autologous whole cell product in the treatment of any solid tumor. The Cochrane Randomized Controlled Trial risk of bias tool was used to assess risk of bias. Eighteen manuscripts were identified with a total of 714 patients enrolled in control and 808 in vaccine arms. In 698 patients receiving at least one dose of vaccine, treatment was well tolerated with a total of 5 grade III or higher adverse events. Clinical response was reported in a minority (n = 2, 14%) of studies. Autologous cell vaccines were associated with improved overall (HR 1.28, 95% CI 1.01-1.63) and disease-free survival (HR 1.33, 95% CI 1.05-1.67) over thirteen and ten trials respectively. Where reported, immune assays correlated well with clinical outcomes. Our results suggest that autologous whole cell vaccination is safe and efficacious in increasing survival in patients undergoing treatment for solid tumors.Registration: PROSPERO CRD42019140187.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Cancer Vaccines* / adverse effects
Humans
Immunotherapy
Neoplasms* / therapy

Substances

Cancer Vaccines