809 Time for TEA T Cells Expanded on Artificial Antigen Presenting Cells? Molecular Therapy Volume 18, Supplement 1, May 2010 Copyright © The American Society of Gene & Cell Therapy S312 CANCER IMMUNO[.]
Trang 1Molecular Therapy Volume 18, Supplement 1, May 2010 Copyright © The American Society of Gene & Cell Therapy
S312
CANCER - IMMUNOTHERAPY III
Jurkat clones, we demonstrate that this drug combination does not
signi cantly alter the expression of endogenous genes nearest to the
proviral integration site
806 Highly Ef cient Expression and
Puri cation of Hepatitis C Virus Core Protein in
E.coli
Yixin Bian,1 Guozhen Qiu,1 Tingting Li,1 Zixuan Chen,1 Wenjing
Wang,1 Chengyao Li.1
1 Southern Medical University, Guangzhou, Guangdong, China.
Hepatitis C virus (HCV) infection is major cause of chronic liver
diease and hepatocellular carcinoma, but currently there are no
prophylactic HCV vaccines available Therefore, the early diagnosis
and the early treatment are critical to hepatitis control Although
there are numerous commercial HCV diagnostic antigens available,
their speci city and sensitivity need to be improved HCV core
protein-encoding sequence is among the most conservative genes
in the HCV genome The core protein localizes to the endoplasmic
reticulum (ER) through a C-terminal hydrophobic region that is
cotranslationally inserted into the ER membrane In this study, a 360bp
cDNA encoding 120 amino acid of HCV type-1b core protein, which
lacked the C-terminal hydrophobic region, was ampli ed by PCR, and
then cloned into an expression plasmid pET-28a(+) The recombinant
plasmid pET-28a-core120 was transduced into E.coli BL21 The
expression of the recombinant core protein was induced by IPTG
Then the recombinant protein was puri ed by Ni+ -af nity column
and renatured by G-25 molecular sieve Finally, the expressed HCV
core protein, accounting for 30% of the total protein was identi ed
using SDS-PAGE, western blot and ELISA The results revealed its
speci c immunoreactivity with serum from patients with hepatitis
C In conclusion, high level of the truncated HCV core protein was
expressed in E.coli with high HCV speci city and good antigenicity
It may suggest the application on studying and developing of HCV
diagnostic antigens
807 Molecular Epidemiology of HCV Infection
among Recovery and Chronic Blood Donors in
Guangdong, China
Tingting Li,1 Jinfeng Zeng,2 Zixuan Chen,1 Lifang Shuai,1 Anqi
Wang,1 Chengyao Li.1
1 School of Biotechnology, Southern Medical University,
Guangzhou, Guangdong, China; 2 Shenzhen Blood Center,
Shenzhen, Guangdong, China.
Hepatitis C virus (HCV) infection is gaining importance in Asian
countries in recent years But epidemiological studies conducted on
recovery and chronic blood donors with HCV infection in China are
little known A study was carried out to determine the ratio between
HCV chronic and recovery infection in blood donors from Guangdong,
a province in southern China HCV genotyping and phylogenetic
analyses were also performed A total of 122 antibody positive
plasmas detected by both Lizhu and Ortho anti-HCV EIAs were tested
for viral load, con rmed by Nested-PCR, and then classi ed into
two statuses, chronic or recovery infection Approximately 37.5% of
con rmed anti-HCV carriers had no detectable viral RNA and were
considered to have cleared the virus and recovered from the infection
Chronic samples were ampli ed by 5’-NCR PCR and sequenced for
genotyping (215-218bp) The result showed genotype 1 (29.3%),
2(8.3%), 3 (29.3%), 6 (33.3%) was present in chronic blood donors
This initial study will help us to understand HCV infection among
recovery and chronic blood donors in China
808 Occult Hepatitis B Virus Infection in Shenzhen, China
Xin Zheng,1 Yixin Bian,2 Ling Zhang,1 Wenjing Wang,1 Lifang Shuai,3 Anqi Wang,1 Jean-Pierre Allain,4 Daniel Candotti,4
Chengyao Li.1
1 School of Biotechnology, Southern Medical University, Guangzhou, Guangdong, China; 2 Shenzhen Blood Centre, Shenzhen, China; 3 Guangzhou Centre of Disease Control of PLA, Guangzhou, China; 4 Department of Haematology, London, United Kingdom.
Characterization of occult HBV infection(OBI) in blood donors in China remains far unknown This study is to explore the molecular characterization of occult hepatitis B virus (HBV) infection in blood donors in Shenzhen, China The HBsAg negative donors plasmas collected for HBV/HCV/HIV screening from 2003 by the ELISA were detected for HBV DNA by Nucleic Acid Testing (NAT) in blood donors from Shenzhen blood center All samples of China origin OBIs were quanti ed for HBV DNA loads by real-time PCR(QPCR) The ampli ed basic core promoter/precore, pre-S/S, and whole genome were cloned and sequenced, phylogenetic analysis were performed based on one to three sequences of HBV clones Twenty-nine samples
of OBI screened from 165371 donors were con rmed and genotyped, according to sequences of Pre-S/S region Genotype C was more frequent (8 strains) than genotype B (5 strains) OBI donors were obtained for 8 females (27.6%) and 21males(72.4%) Viral load ranged between unquanti able and 7321IU/ml (median 17.4IU/ml)
Sequence analyses of full length genome showed occult isolates were variants from clones The amino acid substitutions of core and pre-s/s open reading frame in OBI were more frequent than HBsAg+
sample in genotype B(P< 0.03), but not in the core region of genotype C(P>0.05) Frequency of diversity of core regular element in OBIs was signi cantly higher than that in wildtype HBV(P<0.01) Amino acid substitutions were concentrated in the immunoreactive regions
of the Pre-S/S and core proteins.Twelve OBI samples were mutated
in B cell epitope and CD8+ T cell epitope of pre-S/S while 7 OBI samples were mutated in B cell epitope and CD4+ Th cell epitope and CTL of core region There were deletions in pre-s/s and insertion
in CURS region.The results suggested that mutations happened in regular element and immunoreactive region on the HBV pre-S/S and core proteincould affect HBV replication
Cancer – Immunotherapy III
809 Time for TEA: T Cells Expanded on Arti cial Antigen Presenting Cells?
Hillary N Gibbons,1 Carrie Yuen,1 Sergio Giralt,2 Carl H June,3,4
Laurence J N Cooper.1
1 Pediatrics, M.D Anderson Cancer Center, Houston, TX; 2 Stem Cell Transplantation, M.D Anderson Cancer Center, Houston, TX;
3 Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA; 4 Abramson Cancer Research Institute, University of Pennsylvania Medical Center, Philadelphia, PA.
Patients who rapidly recover their absolute lymphocyte count (ALC) after ablative therapy have improved disease-free and event-free survival Therefore, we developed a method using arti cial antigen presenting cells (aAPC) to numerically expand T cells from peripheral blood mononuclear cells (PBMC) and umbilical cord blood (UCB) for adoptive transfer A clinically-appealing approach
to rapidly expand T cells was based upon using banked clinical-grade aAPC derived from irradiated K562 that had been modi ed to express the T-cell costimulatory molecules CD86, and 41BBL and membrane bound version of IL-15 By co-expressing the high af nity Fc receptor, CD64, we were able to load desired monoclonal antibodies, such as
Molecular Therapy Volume 18, Supplement 1, May 2010 Copyright © The American Society of Gene & Cell Therapy S313
CANCER - IMMUNOTHERAPY III
clinical grade anti-CD3 (OKT3) to provide a proliferative signal The T-cell to aAPC ratio was systematically varied (from 10:1 to 1:2) and
T cells were numerically expanded up to 105 fold
Phenotype was examined as a measure of persistence and function
Surprisingly, varying the ratios of aAPC changed the relative outgrowth of CD4+ versus CD8+ T cells The cultures containing the fewest aAPC (10:1) yielded more CD8+ T cells, while the culture with the most aAPC (1:2) yielded more CD4+ T cells (p value = 05)
The aAPC supported the expansion of T-cell populations containing central memory T cells (CD95+CD28+CD62L+) and effector memory
T cells (CD95+CD28negCD62Lneg), suggesting that the culture conditions support a range of T-cell differentiation There were more central memory T cells (CD4+CD62L+CCR7+) when cultured with the fewest aAPC (p value = 0.03) Since programmed death 1 (PD-1) expression is correlated with an inferior anti-tumor response, we demonstrated that T cells cultured with the fewest aAPC showed less PD-1 expression To evaluate function, the T cells were activated and found to produce IL-2 and IFN-g with minimal production of IL-10 and TGF-b These data demonstrate that OKT3-loaded aAPC can
be used to ef ciently propagate T cells containing desired subsets
in a clinically-amenable approach, given that the aAPCs have been prepared as a master cell bank The observation that different ratios
of CD4 and CD8 T cells results in culture based on the aAPC ratio provides a platform to generate desired mixes of these T cells to enhance a therapeutic effect
810 Oxaliplatin Increases the Antitumor Effect
of Vector-Delivered Interleukin-12 Expression
in a Murine Model of Hepatic Colorectal Cancer Metastases
Manuela Gonzalez-Aparicio,1 Itsaso Mauleon,1 Pilar Alzuguren,1
Sandra Hervas-Stubbs,1 Uxua Manchengo,1 Julien Crettaz,1
Gloria González-Aseguinolaza,1 Jose Medina-Echeverz,1 Pedro Berraondo,1 Jesus Prieto,1,2 Ruben Hernandez-Alcoceba.1
1 Gene Therapy and Hepatology, FIMA, Pamplona, Navarra, Spain; 2 CIBERehd, University Clinic of Navarra, Pamplona, Navarra, Spain.
Objectives: The appearance of liver metastases is one of the leading causes of death in colorectal cancer patients New therapeutic options are needed for the management and prevention of this disease Interleukin-12 (IL-12) is an immunostimulatory cytokine with proven antitumor effect in different animal models of this disease Despite evidences indicating its biological effect in humans, neither the recombinant protein nor gene therapy vectors expressing IL-12 have shown a relevant bene t in cancer patients The dif culties in obtaining a suitable expression pattern and the lack of co-stimulatory factors contribute to this poor performance We propose a new approach to overcome these limitations
Methods: A High-Capacity (“gutless”) Adenoviral vector carrying a liver-speci c, Mifepristone-inducible system for the expression of
IL-12 (HC-Ad/RUmIL-IL-12) was used in combination with chemotherapy (oxaliplatin or gemcitabine) Tumors were established in the liver of C57BL/6 mice by inoculation of MC38 colon cancer cells Results: Intrahepatic injection of HC-Ad/RUmIL-12 and tailored induction regimes allowed the maintenance of safe and ef cient levels
of IL-12 in vivo Two cycles of 10 daily inductions were needed to eradicate hepatic lesions A robust stimulation of speci c CD8+ T cell responses was observed, but complete protection against tumor re-challenge was only observed in less than 25% of the animals The incorporation of oxaliplatin (5 mg/kg) three days before starting the induction regime achieved (i) increased stimulation of the immune response against cancer cells (ii) efficient elimination of liver metastases with a single cycle of IL-12 induction and (iii) improved protection or response against an experimental tumor re-challenge
In contrast, gemcitabine (60 mg/kg) cooperated with a single cycle of IL-12 expression, but was not bene cial in the long-term management
of tumor-bearing mice, in part due to the toxicity of the combined protocol
Conclusions: Long-term controlled expression of IL-12 using a
HC-Ad vector in combination with oxaliplatin is effective and clinically applicable against hepatic colon cancer metastases
811 Optimizing Dendritic Cell Vaccination
by Combination with Oncolytic Adenovirus Coexpressing Interleukin-12 and Granulocyte-Macrophage Colony Stimulating Factor
Song-Nan Zhang,1 Jing-Hua Huang,2 Ji Young Yoo,3 Kyung-Ju Choi,4 Chae-Ok Yun.5
1 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 2 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 3 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 4 Brain Korea
21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 5 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.
Dendritic cell (DC)-based vaccination is a promising strategy for cancer immunotherapy However, clinical trials have indicated that DC vaccination alone is insuf cient to effectively treat cancer patients Immunosuppressive microenvironments induced by tumors
Trang 2Molecular Therapy Volume 18, Supplement 1, May 2010 Copyright © The American Society of Gene & Cell Therapy
S312
CANCER - IMMUNOTHERAPY III
Jurkat clones, we demonstrate that this drug combination does not
signi cantly alter the expression of endogenous genes nearest to the
proviral integration site
806 Highly Ef cient Expression and
Puri cation of Hepatitis C Virus Core Protein in
E.coli
Yixin Bian,1 Guozhen Qiu,1 Tingting Li,1 Zixuan Chen,1 Wenjing
Wang,1 Chengyao Li.1
1 Southern Medical University, Guangzhou, Guangdong, China.
Hepatitis C virus (HCV) infection is major cause of chronic liver
diease and hepatocellular carcinoma, but currently there are no
prophylactic HCV vaccines available Therefore, the early diagnosis
and the early treatment are critical to hepatitis control Although
there are numerous commercial HCV diagnostic antigens available,
their speci city and sensitivity need to be improved HCV core
protein-encoding sequence is among the most conservative genes
in the HCV genome The core protein localizes to the endoplasmic
reticulum (ER) through a C-terminal hydrophobic region that is
cotranslationally inserted into the ER membrane In this study, a 360bp
cDNA encoding 120 amino acid of HCV type-1b core protein, which
lacked the C-terminal hydrophobic region, was ampli ed by PCR, and
then cloned into an expression plasmid pET-28a(+) The recombinant
plasmid pET-28a-core120 was transduced into E.coli BL21 The
expression of the recombinant core protein was induced by IPTG
Then the recombinant protein was puri ed by Ni+ -af nity column
and renatured by G-25 molecular sieve Finally, the expressed HCV
core protein, accounting for 30% of the total protein was identi ed
using SDS-PAGE, western blot and ELISA The results revealed its
speci c immunoreactivity with serum from patients with hepatitis
C In conclusion, high level of the truncated HCV core protein was
expressed in E.coli with high HCV speci city and good antigenicity
It may suggest the application on studying and developing of HCV
diagnostic antigens
807 Molecular Epidemiology of HCV Infection
among Recovery and Chronic Blood Donors in
Guangdong, China
Tingting Li,1 Jinfeng Zeng,2 Zixuan Chen,1 Lifang Shuai,1 Anqi
Wang,1 Chengyao Li.1
1 School of Biotechnology, Southern Medical University,
Guangzhou, Guangdong, China; 2 Shenzhen Blood Center,
Shenzhen, Guangdong, China.
Hepatitis C virus (HCV) infection is gaining importance in Asian
countries in recent years But epidemiological studies conducted on
recovery and chronic blood donors with HCV infection in China are
little known A study was carried out to determine the ratio between
HCV chronic and recovery infection in blood donors from Guangdong,
a province in southern China HCV genotyping and phylogenetic
analyses were also performed A total of 122 antibody positive
plasmas detected by both Lizhu and Ortho anti-HCV EIAs were tested
for viral load, con rmed by Nested-PCR, and then classi ed into
two statuses, chronic or recovery infection Approximately 37.5% of
con rmed anti-HCV carriers had no detectable viral RNA and were
considered to have cleared the virus and recovered from the infection
Chronic samples were ampli ed by 5’-NCR PCR and sequenced for
genotyping (215-218bp) The result showed genotype 1 (29.3%),
2(8.3%), 3 (29.3%), 6 (33.3%) was present in chronic blood donors
This initial study will help us to understand HCV infection among
recovery and chronic blood donors in China
808 Occult Hepatitis B Virus Infection in Shenzhen, China
Xin Zheng,1 Yixin Bian,2 Ling Zhang,1 Wenjing Wang,1 Lifang Shuai,3 Anqi Wang,1 Jean-Pierre Allain,4 Daniel Candotti,4
Chengyao Li.1
1 School of Biotechnology, Southern Medical University, Guangzhou, Guangdong, China; 2 Shenzhen Blood Centre,
Shenzhen, China; 3 Guangzhou Centre of Disease Control of PLA, Guangzhou, China; 4 Department of Haematology, London, United
Kingdom.
Characterization of occult HBV infection(OBI) in blood donors in China remains far unknown This study is to explore the molecular characterization of occult hepatitis B virus (HBV) infection in blood donors in Shenzhen, China The HBsAg negative donors plasmas collected for HBV/HCV/HIV screening from 2003 by the ELISA were detected for HBV DNA by Nucleic Acid Testing (NAT) in blood donors from Shenzhen blood center All samples of China origin OBIs were quanti ed for HBV DNA loads by real-time PCR(QPCR) The ampli ed basic core promoter/precore, pre-S/S, and whole genome were cloned and sequenced, phylogenetic analysis were performed based on one to three sequences of HBV clones Twenty-nine samples
of OBI screened from 165371 donors were con rmed and genotyped, according to sequences of Pre-S/S region Genotype C was more frequent (8 strains) than genotype B (5 strains) OBI donors were obtained for 8 females (27.6%) and 21males(72.4%) Viral load ranged between unquanti able and 7321IU/ml (median 17.4IU/ml)
Sequence analyses of full length genome showed occult isolates were variants from clones The amino acid substitutions of core and pre-s/s open reading frame in OBI were more frequent than HBsAg+
sample in genotype B(P< 0.03), but not in the core region of genotype C(P>0.05) Frequency of diversity of core regular element in OBIs was signi cantly higher than that in wildtype HBV(P<0.01) Amino acid substitutions were concentrated in the immunoreactive regions
of the Pre-S/S and core proteins.Twelve OBI samples were mutated
in B cell epitope and CD8+ T cell epitope of pre-S/S while 7 OBI samples were mutated in B cell epitope and CD4+ Th cell epitope and CTL of core region There were deletions in pre-s/s and insertion
in CURS region.The results suggested that mutations happened in regular element and immunoreactive region on the HBV pre-S/S and
core proteincould affect HBV replication
Cancer – Immunotherapy III
809 Time for TEA: T Cells Expanded on Arti cial Antigen Presenting Cells?
Hillary N Gibbons,1 Carrie Yuen,1 Sergio Giralt,2 Carl H June,3,4
Laurence J N Cooper.1
1 Pediatrics, M.D Anderson Cancer Center, Houston, TX; 2 Stem Cell Transplantation, M.D Anderson Cancer Center, Houston, TX;
3 Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA; 4 Abramson Cancer Research
Institute, University of Pennsylvania Medical Center, Philadelphia, PA.
Patients who rapidly recover their absolute lymphocyte count (ALC) after ablative therapy have improved disease-free and
event-free survival Therefore, we developed a method using arti cial antigen presenting cells (aAPC) to numerically expand T cells from peripheral blood mononuclear cells (PBMC) and umbilical cord blood (UCB) for adoptive transfer A clinically-appealing approach
to rapidly expand T cells was based upon using banked clinical-grade aAPC derived from irradiated K562 that had been modi ed to express the T-cell costimulatory molecules CD86, and 41BBL and membrane bound version of IL-15 By co-expressing the high af nity Fc receptor, CD64, we were able to load desired monoclonal antibodies, such as
Molecular Therapy Volume 18, Supplement 1, May 2010 Copyright © The American Society of Gene & Cell Therapy S313
CANCER - IMMUNOTHERAPY III
clinical grade anti-CD3 (OKT3) to provide a proliferative signal The T-cell to aAPC ratio was systematically varied (from 10:1 to 1:2) and
T cells were numerically expanded up to 105 fold
Phenotype was examined as a measure of persistence and function
Surprisingly, varying the ratios of aAPC changed the relative outgrowth of CD4+ versus CD8+ T cells The cultures containing the fewest aAPC (10:1) yielded more CD8+ T cells, while the culture with the most aAPC (1:2) yielded more CD4+ T cells (p value = 05)
The aAPC supported the expansion of T-cell populations containing central memory T cells (CD95+CD28+CD62L+) and effector memory
T cells (CD95+CD28negCD62Lneg), suggesting that the culture conditions support a range of T-cell differentiation There were more central memory T cells (CD4+CD62L+CCR7+) when cultured with the fewest aAPC (p value = 0.03) Since programmed death 1 (PD-1) expression is correlated with an inferior anti-tumor response, we demonstrated that T cells cultured with the fewest aAPC showed less PD-1 expression To evaluate function, the T cells were activated and found to produce IL-2 and IFN-g with minimal production of IL-10 and TGF-b These data demonstrate that OKT3-loaded aAPC can
be used to ef ciently propagate T cells containing desired subsets
in a clinically-amenable approach, given that the aAPCs have been prepared as a master cell bank The observation that different ratios
of CD4 and CD8 T cells results in culture based on the aAPC ratio provides a platform to generate desired mixes of these T cells to enhance a therapeutic effect
810 Oxaliplatin Increases the Antitumor Effect
of Vector-Delivered Interleukin-12 Expression
in a Murine Model of Hepatic Colorectal Cancer Metastases
Manuela Gonzalez-Aparicio,1 Itsaso Mauleon,1 Pilar Alzuguren,1
Sandra Hervas-Stubbs,1 Uxua Manchengo,1 Julien Crettaz,1
Gloria González-Aseguinolaza,1 Jose Medina-Echeverz,1 Pedro Berraondo,1 Jesus Prieto,1,2 Ruben Hernandez-Alcoceba.1
1 Gene Therapy and Hepatology, FIMA, Pamplona, Navarra, Spain; 2 CIBERehd, University Clinic of Navarra, Pamplona, Navarra, Spain.
Objectives: The appearance of liver metastases is one of the leading causes of death in colorectal cancer patients New therapeutic options are needed for the management and prevention of this disease Interleukin-12 (IL-12) is an immunostimulatory cytokine with proven antitumor effect in different animal models of this disease Despite evidences indicating its biological effect in humans, neither the recombinant protein nor gene therapy vectors expressing IL-12 have shown a relevant bene t in cancer patients The dif culties in obtaining a suitable expression pattern and the lack of co-stimulatory factors contribute to this poor performance We propose a new approach to overcome these limitations
Methods: A High-Capacity (“gutless”) Adenoviral vector carrying a liver-speci c, Mifepristone-inducible system for the expression of
IL-12 (HC-Ad/RUmIL-IL-12) was used in combination with chemotherapy (oxaliplatin or gemcitabine) Tumors were established in the liver of C57BL/6 mice by inoculation of MC38 colon cancer cells Results: Intrahepatic injection of HC-Ad/RUmIL-12 and tailored induction regimes allowed the maintenance of safe and ef cient levels
of IL-12 in vivo Two cycles of 10 daily inductions were needed to eradicate hepatic lesions A robust stimulation of speci c CD8+ T cell responses was observed, but complete protection against tumor re-challenge was only observed in less than 25% of the animals The incorporation of oxaliplatin (5 mg/kg) three days before starting the induction regime achieved (i) increased stimulation of the immune response against cancer cells (ii) efficient elimination of liver metastases with a single cycle of IL-12 induction and (iii) improved protection or response against an experimental tumor re-challenge
In contrast, gemcitabine (60 mg/kg) cooperated with a single cycle of IL-12 expression, but was not bene cial in the long-term management
of tumor-bearing mice, in part due to the toxicity of the combined protocol
Conclusions: Long-term controlled expression of IL-12 using a
HC-Ad vector in combination with oxaliplatin is effective and clinically applicable against hepatic colon cancer metastases
811 Optimizing Dendritic Cell Vaccination
by Combination with Oncolytic Adenovirus Coexpressing Interleukin-12 and Granulocyte-Macrophage Colony Stimulating Factor
Song-Nan Zhang,1 Jing-Hua Huang,2 Ji Young Yoo,3 Kyung-Ju Choi,4 Chae-Ok Yun.5
1 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 2 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 3 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 4 Brain Korea
21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea; 5 Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.
Dendritic cell (DC)-based vaccination is a promising strategy for cancer immunotherapy However, clinical trials have indicated that DC vaccination alone is insuf cient to effectively treat cancer patients Immunosuppressive microenvironments induced by tumors