NEOadjuvant Dendritic Cell Vaccination for Ovarian Cancer

Prior treatment

• Unable and/or unwilling to undergo standard chemotherapy and interval debulking surgery
• Chronic treatment with systemic immunosuppressive drugs (i.e. more than 10 mg prednisolone equivalent)

Other illness

• Recurrent ovarian cancer
• Histologies other than high grade serous ovarian cancer such as, but not restricted to, endometrioid, mucinous, clear cell or carcinosarcoma
• Any serious clinical condition that may interfere with the safe administration of DC vaccinations
• Heart failure (NYHA class III/IV)
• Any uncontrolled co-morbidity, e.g. psychiatric or social conditions interfering which participation
• Active infection of Hepatitis B, C, HIV and syphilis
• Serious other active infections
• Known allergy to shell fish
• Auto immune disease (exception: vitiligo is permitted)
• History of organ allografts

Age

• History of any second malignancy, with the exception of adequately treated basal cell carcinoma, cervical cancer \> 5 years ago or early stage breast cancer \>10 years ago.

Other

• FIGO stage I-IIb, IIIa or IVb with liver, spleen or lung metastases or lymph nodes above the diaphragm or in the groins \> 1 cm
• Unable to undergo a tumor biopsy
• Pregnancy or insufficient anti-conception if reproduction is still possible

• Women over 18 years old with histologically confirmed primary epithelial ovarian cancer.
• Not amenable by primary debulking surgery and in need of neoadjuvant chemotherapy and interval debulking
• High-grade or low grade serous histology
• FIGO stage IIIb, IIIc, IVa or IVb if only lymph nodes ≤ 1cm above the diaphragm or in the groins
• Extensive abdominal spread of tumor
• WHO/ECOG performance status 0-1
• Neutrophils \>1.5x 109/L, platelets \>100x 109/L, hemoglobin \>5,6 mmol/L (9.0 g/dl), estimated glomerular filtration rate \> 45 ml/min/1.73m2 , AST/ALT \<3 x ULN, serum bilirubin \<1.5 x ULN (exception: Gilbert's syndrome is permitted)
• Expected adequacy of follow-up
• Postmenopausal or evidence of non-childbearing status or for women of childbearing potential: negative urine or serum pregnancy test, within 28 days of study treatment and confirmed prior to treatment on day 1. Postmenopausal is defined as:
  • Amenorrhoeic for 1 year or more following cessation of exogenous hormonal treatments;
  • or surgical sterilisation (bilateral oophorectomy or hysterectomy).
• Informed consent