DCVax®-L is a vaccine, developed by Northwest Biotherapeutics, that is made from each patient's own dendritic cells. Dendritic cells are a type of immune cell that function to help the body's immune system recognise and attack tumour cells.
The process of making a dendritic cell vaccine is complex and involves taking both tumour cells and blood from the patient. Immune cells are separated from the patient's blood and exposed to the tumour cells – it is through this process that dendritic cells learn to recognise the specific markers and proteins associated with the patient's tumour cells. The “educated" dendritic cells are then injected back into the patient where they go on to recruit and “teach" other immune cells to recognise and attack the cancerous cells.
The vaccine is administered by an intra-dermal injection in the arm (this goes into the skin, rather than muscle, similar to a flu jab).
In order to produce DCVax®-L, two to three grams of frozen tumour tissue are usually required to make the eleven-shot three year cycle of DCVax®-L injections. If tumour tissue has been frozen, it must have been saved without any chemicals or preservatives, and not in saline or blocks of paraffin. Unfortunately tumour banks and pathology departments frequently use paraffin or other preservatives that render the tissue unusable for the DCVax®-L manufacturing process.
Some surgeons use polymer wafers. These wafers are soaked with a type of chemotherapy which is meant to kill tumour cells, and are placed in the tumour cavity in the brain when the tumour is surgically removed. If this treatment was used then DCVax®-L is usually not a treatment option because the chemotherapy drugs from the wafer will also kill immune cells which enter the tumour cavity to fight residual tumour cells.
The clinical trial is currently closed. Interim results published in May 2018 showed indications of an increase in overall survival for patients with glioblastoma. Patients in the trial who received DC Vax®-L showed an average survival rate of 23.1 months compared to an average overall survival rate between 15-17 months compared to historic controls.
The Brain Tumour Charity submitted a patient organisation consultation response in August 2018 to contribute towards the National Institute for health and Care Excellence (NICE) technology appraisal of the treatment. The Charity will now be a part of a NICE appraisal committee where researchers, clinicians, patient representatives and relevant bodies will be brought together to discuss the treatment's suitability for uptake. NICE will measure whether or not the treatment represents better value for money than other treatments that would be neglected if the expenditure took place.
If DCVax®-L is approved by NICE and then receives full regulatory approval, the NHS legally has to make the treatment available within three months.
The vaccine can currently be accessed privately and interested individuals are encouraged to speak to their clinicians with the provided information.
The cost of the DCVax®-L is currently undetermined, as the vaccine is currently being developed and requires approval from the MHRA. Your clinician will be able to provide you with more information regarding privately funding the treatment.