Dendritic Cell Therapy for Cancers- Denvax


Current standard treatment modalities in cancer therapy include surgery, chemotherapy and radiotherapy. Despite significant advances in standard cancer

therapies during the last decades, one challenge of current treatment strategies is the development of “daughter” tumors (metastases). The spread of

tumors, or metastases, is still the most common cause of death from cancer.



The DENVAX is dendritic cell-based cancer immunotherapy for solid cancers in various stages of the disease. It is autologous treatment, which involves

patient's own mononuclear cells transformed into cancer-specific dendritic cells.Designed to be specific, DENVAX targets only the cancer cells without

harming the healthy ones. It is safe and effective and works best to prevent relapse and recurrences, the major cause of mortality and morbidity.

DENVAX helps in correcting the failed immune surveillance and teaches the immune system to recognize and kill cancer cells.


Why do cancers relapse ?

A cancer relapse occurs because in spite of the best efforts to get rid of cancer, some cancer cells are left behind. These cancer cells remain dormant for a

period of time, but eventually they continue to multiply resulting in the recurrence or relapse.


What is the best way to treat relapse ?

Cancer treatment modalities like surgical resection, chemotherapy and/or radiation are mostly ineffective in controlling the micrometastasis. Micrometastases

are single tumor cells or clusters of cells shed by solid cancers and disseminated in various organs of the body. Micrometastases have a pronounced clinical

effect, are hard to detect and can be the starting point of recurrence of cancer.

DENVAX targets the micrometastasis and destroys the disseminated cancer cells, thereby preventing its development, slowing the spread of cancer and

improving the life expectancy.



Dendritic cells are cells of the immune system. Their main function is to process antigen material and present it on the surface to other cells of the immune

system. They function as antigen presenting cells and therefore act as messengers between the innate and acquired immunity.

Dendritic cells were discovered by the scientist Ralph Steinman in the year 1972. For discovering the central role of dendritic cells in controlling the adaptive

immune responses, Steinman has been awarded the Nobel Prize in Physiology or Medicine of 2011.




DENVAX is dendritic cell-based cancer immunotherapy. Dendritic cells (DC) therapy delays cancer progression and improves patient survival. We have treated

a number of patients with M1 (metastatic) disease who are leading a recurrence-free quality life for many months to years. We have the experience in

treating more than a thousand patients suffering from cancer in various stages of the disease.



DENVAX shows most promise at preventing a recurrence of cancer after surgery, chemotherapy or radiation because the immune system will need to

recognize and attack a smaller number of cancer cells.



DENVAX can be given alone or in combination with the other treatment modalities. Dendritic cell therapy comes under the heading of Biological Therapy of

Cancer, the fourth modality of cancer treatment after surgery, radiation and chemotherapy.



DENVAX is customized treatment. It is designed to be safe and has minimal side effects. Some patients may experience fever for a day or two after taking

DENVAX therapy. The components of DENVAX include patient's own mononuclear cells manipulated into cancer-fighting dendritic cells; there is no graft versus

host reaction, or acute-or delayed-type hypersensitivity.



To manufacture DENVAX, patient's own mononuclear cells are collected either by drawing a fresh sample of peripheral blood or by apheresis procedure. The

CD14+ cells are isolated and further processed for 8 days to transform them into cancer-specific DC. These dendritic cells are then re-infused into the same

patient on the 8th day of drawing blood.



What are Dendritic cells and how are they useful ?

Dendritic cells are blood cells present in every person's bloodstream. They function as an immune cell but are present in small numbers. They identify cancer

cells, process them into bits, and jumpstart the immune response by bringing the foreign substance to the attention of the rest of the immune system (T

cells). The activated immune system is then able to circulate throughout the body and destroy the cancer cells.


What happens in Cancer ?

In cancer, the immune system fails; cells of the immune system fail to recognize the cancer cells. The immune system doesn't "see" tumors as dangerous or

foreign, and doesn't mount a strong attack against them. Another reason tumors may not stimulate an immune response is that the cancer cells develop

ways to escape the immune system.


What is DENVAX (Dendritic cell therapy) ?

Cancer occurs because the immune system has failed. Numerous researches now prove that this defect in the immune system can be corrected outside the

body (ex vivo technology).

DENVAX is dendritic cell therapy, which involves the extraction of mononuclear (CD14+) cells from the patient's own blood, transformation of these cells into

cancer-fighting cells and giving back to the patient.


What kind of cancers can be treated by DENVAX therapy ?

This includes solid tumors mainly, including cancers of the bladder, bone, brain, breast, head & neck, gallbladder, kidney, liver, lung, lymphoma, multiple

myeloma, ovarian, pancreatic, prostate, stomach, and testicular.


At what cancer stage should a patient consider DENVAX therapy ?

A patient may consider DENVAX therapy when:

  • The patient is free of disease but at a risk of recurrence
  • Palliation is required
  • patient requires immune-therapy in addition to ongoing chemo/radiation therapy


Who will benefit most from the therapy ?

DENVAX works best in patients

  • Who opt early during the disease progression.
  • Who opt immediately after surgery, when tumor load is minimal.


How is DENVAX prepared ?

Mononuclear (CD14+) cells are extracted from the patient's peripheral blood. These cells are cultured, exposed to maturation stimuli and then re-infused into

the same patient on the the 8th day of blood collection.


How are Dendritic cells made to recognize the patient's tumor cells ?

Dendritic cells should recognize the patient's tumor cells and target them once inside the body. But before that they must undergo 'maturation'. For this the

dendritic cells are exposed to tumor antigen-self or non-self.


How is DENVAX administered ?

DENVAX is administered as an infusion in 100ml DNS, in twenty minutes.


What are the side effects of DENVAX ?

There are minimal side effects. Some patients may experience mild-moderate grade fever after vaccine administration lasting 24-48 hours. Some may

experience lethargy/weakness for few days.


Are there any contraindications for this therapy ?

There are no contraindications to this therapy.


Are any drugs or procedures used as part of the Dendritic Cell Therapy ?

Immune adjuvants are used to enhance the immune system during Dendritic Cell Therapy.



  • Denvax can be given alone or in combination with other modalities of cancer treatment
  • Dendritic cell therapy comes under the fourth modality of cancer treatment, called Immunotherapy; the other three are surgery, radiation and chemotherapy.
  • Denvax given concurrently with chemotherapy helps in alleviating the adverse effects of the chemotherapy.
  • Denvax are patient’s own mononuclear cells manipulated into cancer-fighting dendritic cells; thus there is no graft versus host reaction, nor chances of acute or delayed type hypersensitivity.
  • Best responders to Denvax are patients who have completed conventional therapy but are in the vulnerable high relapse group.
Cancerous antigens are bits of protein required for maturation of dendritic cells. This cancerous antigen may be extracted from either source:

a) The patient's Wax Embedded Tissue: tumor tissue preserved in wax for biopsy examination for further studies;
b) Formalin Fixed Tissue: patient’s tumor tissue preserved in formalin at the time of surgery for further studies;
c) Fresh FNA Tissue: fresh sample of tumor tissue derived from fine needle aspiration.


The cancerous antigens derived from patient's own tumor tissue are called tumor associated antigens, or TAAs. In cases where self-tumor antigens are not

available, non-self tumor antigens are used for dendritic cell maturation. The non-self antigens are derived from different sources, similar in nature, and

called tumor specific antigens, or TSAs.



DENVAX is indicated as adjunctive immunological therapy (adjuvant treatment plan) for the management of patients in stage IV cancers, who are not

satisfactorily controlled by chemotherapy, surgery and radiotherapy. This therapy is proposed to be useful in preventing relapses and recurrences in treated

patients of solid cancer, non-Hodgkin’s lymphoma and multiple myeloma.


DENVAX is given regularly at 3-4 weeks interval for the initial six months, in order to prevent relapse and recurrence, in CR (complete remission patients, or

patients with minimal tumor load). It may be continued for life for patients seeking palliation in advanced stage disease, wherein the aim is to control the

disease progression and/or improve quality of life.


Maintenance doses of DENVAX are given at monthly intervals. As there are no drug interactions of DENVAX with commonly used chemotherapy drugs, the

therapy can be continued for life in palliative care settings.


DENVAX can be concomitantly given with chemotherapy or radiation therapy but should preferably be given before or after 72 hrs of chemotherapy. During

this period the dendritic cells effectively settle down in lymph nodes and generate T- and B- cell immunity for generating effective anti-cancer immunology.


The treatment can be stopped abruptly without causing any known adverse effects.