高危癌症的很多希望都寄托在免疫疗法上，但由于单药疗法的稀有性和疗效有限，缺乏针对儿童的证据。在这里，我们的目标是在现实场景中使用 N-of-1 方法评估包含个性化树突状细胞 (DC) 疫苗的多模式治疗对复发和/或高风险实体瘤儿童的有效性。在 4 年随访期间，48 名患者总共发生了 160 起可评估事件。该队列的总生存期为 7.03 年。 53.8%的患者接种疫苗后疾病得到控制。比较生存分析显示，DC 疫苗对初次诊断后 2 年以上（HR = 0.53，P = .048）或疾病控制的患者（HR = 0.16，P = .00053）具有有益效果。表明与节拍环磷酰胺和/或长春花碱具有协同效应的趋势（HR = 0.60 P = .225）。 DC疫苗引发后发现免疫检查点抑制剂（ICIs）具有很强的协同效应（HR = 0.40，P = .0047）。总之，个性化 DC 疫苗是多模式个体化治疗的有效组成部分。个性化 DC 疫苗对负担较轻或惰性较弱的疾病有效，具有良好的安全性，并与节拍和/或免疫调节剂具有协同作用。© 2024 作者。约翰·威利出版的《国际癌症杂志》

A lot of hope for high-risk cancers is being pinned on immunotherapy but the evidence in children is lacking due to the rarity and limited efficacy of single-agent approaches. Here, we aim to assess the effectiveness of multimodal therapy comprising a personalized dendritic cell (DC) vaccine in children with relapsed and/or high-risk solid tumors using the N-of-1 approach in real-world scenario. A total of 160 evaluable events occurred in 48 patients during the 4-year follow-up. Overall survival of the cohort was 7.03 years. Disease control after vaccination was achieved in 53.8% patients. Comparative survival analysis showed the beneficial effect of DC vaccine beyond 2 years from initial diagnosis (HR = 0.53, P = .048) or in patients with disease control (HR = 0.16, P = .00053). A trend for synergistic effect with metronomic cyclophosphamide and/or vinblastine was indicated (HR = 0.60 P = .225). A strong synergistic effect was found for immune check-point inhibitors (ICIs) after priming with the DC vaccine (HR = 0.40, P = .0047). In conclusion, the personalized DC vaccine was an effective component in the multimodal individualized treatment. Personalized DC vaccine was effective in less burdened or more indolent diseases with a favorable safety profile and synergized with metronomic and/or immunomodulating agents.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.