American council on ECP (ACE): Why now?

Area of Science:

• Immunology
• Bioengineering
• Hematology

Background:

• Extracorporeal photochemotherapy (ECP) efficacy is increasingly understood.
• The American Council on ECP (ACE) convened experts to establish consensus on ECP's future.
• Current ECP is a one-size-fits-all therapy with simultaneous immunizing and tolerizing effects.

Purpose of the Study:

• To guide the scientific evolution of ECP.
• To establish consensus on nine pivotal points for ECP's clinical application.
• To enable polarization of ECP for specific therapeutic goals.

Main Methods:

• Convening thirty ECP experts across cancer, transplantation, and autoimmunity.
• Conducting a two-day consensus meeting.
• Achieving unanimous agreement on nine key ECP principles.

Main Results:

• ECP must transition to a scientifically driven phase.
• ECP can be polarized to be either immunizing or tolerizing.
• ECP's mechanism involves dendritic antigen-presenting cells (DCs).
• UVA-8-MOP-impacted DCs induce tolerance, while UVA-8-MOP-spared DCs induce immunity.

Conclusions:

• ECP's future requires tailored polarization for cancer or transplantation.
• ECP shows promise for treating cutaneous T cell lymphoma (CTCL) via enhanced immunity.
• ECP's tolerizing capacity for allotransplants warrants further investigation.
• Six pilot clinical trials are recommended, including CTCL, GVHD, and stem cell transplants.