# Complete Response in Recurrent End-Stage Pancreatic Cancer After Combined Immune Cell Therapy of α-Galactosylceramide Dendritic Cell Vaccine Therapy, Wilms’ Tumor 1 Dendritic Cell Vaccine and Natural Killer Cell Therapy

## TL;DR

A patient with advanced recurrent pancreatic cancer showed complete response after combined immune cell therapy without chemotherapy.

## Contribution

Demonstrates successful immune cell therapy combining α-Galcer DC vaccine, WT-1 vaccine, and NK cells in a recurrent pancreatic cancer case.

## Key findings

- PET-CT scans showed regression of cancer and metastasis regions after three months of therapy.
- Tumor markers like CA19-9 and DU-PAN-2 significantly decreased during treatment.
- Immune profile improved with reduced neutrophil percentage and increased lymphocyte percentage.

## Abstract

Pancreatic cancer exhibits high mortality and morbidity, and the prognosis worsens when recurrence occurs. Current standard treatments, such as chemotherapy or radiation, show limited efficacy in recurrent end-stage pancreatic cancer. A man in his 70s visited our facility with a diagnosis of recurrent end-stage pancreatic cancer (Stage Ⅳ) with multiple metastases to mesenteric and paratracheal lymph nodes and the right liver lobe. Due to the severe side effects, chemotherapy was not an option anymore. After apheresis, a combined immune cell-based therapy incorporating α-galactosylceramide (α-Galcer)-pulsed dendritic cell (DC) vaccine therapy into Wilms' tumor 1 (WT-1) vaccine and natural killer (NK) cell therapy was initiated. On completing a nearly three-month course of seven administrations of each therapy, follow-up positron emission tomography-computed tomography (PET-CT) scans showed the regression of the recurrent cancer region as well as the metastasis regions. Meanwhile, chemotherapy was not provided. A significant decrease in tumor-associated markers (i.e., CA19-9, from 88.3 to 54.4 U/mL; DU-PAN-2, from 267 to 76 U/mL) and improvement in the immune profile status (i.e., neutrophil percentage decreased from 68% to 64.2%; lymphocyte percentage increased from 18% to 25.6%, and neutrophil-lymphocyte ratio decreased from 3.8 to 2.5) were observed. His performance status initially deteriorated (to 1 or 2), but improved to 0 without any disability and limiting daily life. Any adverse events or side effects associated with the immune cell-based therapy were not recorded. This single-patient case report demonstrated the clinical potential of incorporating α-Galcer DC vaccine therapy into WT-1 vaccine and NK cell therapy to enhance the anti-tumor effects of immune cell-based therapy. While this case report provided significant insights to facilitate future research, further observations and investigations are warranted with the ultimate goal of improving outcomes in patients with advanced cancers.