Department of Pulmonary Disease, Shanghai Chest Hospital, 241#, West Huaihai Road, Shanghai, China.
Cancer Immunol Immunother. 2011 Oct;60(10):1497-502. doi: 10.1007/s00262-011-1060-0. Epub 2011 Jun 17.
Lung cancer is the leading cause for cancer-related mortality and morbidity, and the survival of late-stage non-small cell lung cancer (NSCLC) remains poor. We hereby evaluate conventional chemotherapy followed by immunotherapy using dendritic cells and cytokine-induced killer cells in the treatment for late stage of NSCLC.
Twenty-eight untreated patients suffered from IIIB to IV NSCLC were enrolled in the study between August 2004 and October 2005, and all received four courses of vinorelbine-platinum (NP) chemotherapy. Fourteen of them received conventional NP chemotherapy followed by vaccinated with CEA (605-613) peptide-pulsed autologous dendritic cells and CIK cells. Vaccination was repeated at 30-day intervals for 4 cycles. The adverse effects, time to progression (TTP), and overall survival (OS) in each group were evaluated.
The adverse effect as a result of chemoimmunotherapy was mild and tolerable. Rash, acne, and pruritus were more frequent in the chemoimmunotherapy group than in the chemotherapy group (64.2% vs. 7.1%, P = 0.004). Non-infectious fever was more frequent in the chemoimmunotherapy group than in the chemotherapy group (71.4% vs. 21.4% P = 0.02). Less grade 3/4 fatigue was observed in patients receiving chemoimmunotherapy: 7.1% versus 57.1% in chemotherapy group, P = 0.01. Compared with patients in chemotherapy group, time to progression in chemoimmunotherapy significantly prolonged, with the median improved from 5.2 months (95% CI: 3.3-6.0) to 6.9 months (95% CI: 5.0-8.8) (P = 0.03). The 1-, 2-, and 5-year survival rates were 64.3, 49, and 21.0%, respectively in chemoimmunotherapy group. Overall survival rate showed no statistically difference between two groups (P = 0.18).
Chemoimmunotherapy could alleviate adverse effects of conventional chemotherapy and prolong survival for patients with late-stage NSCLC.
肺癌是癌症相关死亡和发病的主要原因，晚期非小细胞肺癌（NSCLC）的生存率仍然较差。我们在此评估常规化疗后使用树突细胞和细胞因子诱导的杀伤细胞进行免疫治疗在治疗晚期 NSCLC 中的作用。
2004 年 8 月至 2005 年 10 月期间，共纳入 28 例未经治疗的 IIIB 至 IV 期 NSCLC 患者，均接受 4 个周期的长春瑞滨联合铂类（NP）化疗。其中 14 例患者在常规 NP 化疗后接受 CEA（605-613）肽脉冲自体树突细胞和 CIK 细胞免疫治疗。接种疫苗每 30 天重复一次，共 4 个周期。评估两组患者的不良反应、无进展生存期（TTP）和总生存期（OS）。
化疗免疫治疗的不良反应轻微且可耐受。皮疹、痤疮和瘙痒在化疗免疫治疗组比化疗组更常见（64.2%比 7.1%，P=0.004）。非感染性发热在化疗免疫治疗组比化疗组更常见（71.4%比 21.4%，P=0.02）。化疗免疫治疗组患者的 3/4 级疲劳发生率较低：7.1%比化疗组的 57.1%，P=0.01。与化疗组患者相比，化疗免疫治疗组的无进展生存期显著延长，中位无进展生存期从 5.2 个月（95%CI：3.3-6.0）改善至 6.9 个月（95%CI：5.0-8.8）（P=0.03）。化疗免疫治疗组的 1、2 和 5 年生存率分别为 64.3%、49%和 21.0%。两组患者的总生存率无统计学差异（P=0.18）。
化疗免疫治疗可减轻常规化疗的不良反应，延长晚期 NSCLC 患者的生存时间。
