Amarillo Veterans Affairs Health Care System, Amarillo, TX 79106, USA.
J Immunother. 2012 Feb-Mar;35(2):196-204. doi: 10.1097/CJI.0b013e318243f213.
The objective was to evaluate the toxicity and feasibility of intraperitoneal infusion of tumor-specific cytotoxic T lymphocytes (CTL) as therapy for recurrent ovarian cancer, and to determine if repetitive cycles of CTL generation and infusion measurably increases the host's ovarian cancer immune response. In this study, 7 subjects with recurrent ovarian cancer confined to the peritoneal cavity underwent up to 4 cycles, each cycle beginning with a leukapheresis for collection of precursor lymphocytes, which were stimulated in vitro with mucin 1, a tumor-specific antigen found commonly in ovarian cancer cells. The resulting new CTL for each cycle were reintroduced into the host by intraperitoneal infusion. Immunologic parameters (killer cells, cytokine production, memory T lymphocytes, and natural killer cells) were studied. Toxicity, CA-125, and survival data were also evaluated. The tumor marker CA-125 was nonstatistically significantly reduced after the first month of immunotherapy. However, after that it rose. Killer cells, cytokine production, and memory T lymphocytes increased after the first cycle of stimulation, but plateaued or reduced thereafter. The percent of natural killer cells inversely correlated with other immune parameters. Median survival was 11.5 months. One subject is free of disease since December, 2000. Multiple cycles, beyond 1 cycle, of T-cell stimulation followed by adoptive T-cell infusion, may not enhance the in vivo immune response.
目的是评估腹腔内输注肿瘤特异性细胞毒性 T 淋巴细胞(CTL)作为复发性卵巢癌治疗的毒性和可行性,并确定 CTL 生成和输注的重复循环是否可测量地增加宿主的卵巢癌免疫反应。在这项研究中,7 名复发性卵巢癌局限于腹腔的患者接受了多达 4 个周期的治疗,每个周期从白细胞分离术开始,以收集前体细胞淋巴细胞,然后用粘蛋白 1(一种常见于卵巢癌细胞的肿瘤特异性抗原)在体外刺激这些细胞。每个周期的新 CTL 通过腹腔内输注重新引入宿主。研究了免疫参数(杀伤细胞、细胞因子产生、记忆 T 淋巴细胞和自然杀伤细胞)。还评估了毒性、CA-125 和生存数据。肿瘤标志物 CA-125 在免疫治疗后的第一个月非统计学显著降低。然而,之后它又上升了。在第一轮刺激后,杀伤细胞、细胞因子产生和记忆 T 淋巴细胞增加,但此后达到平台期或减少。自然杀伤细胞的百分比与其他免疫参数呈负相关。中位生存期为 11.5 个月。自 2000 年 12 月以来,1 名患者无疾病。多次循环,超过 1 个周期,T 细胞刺激后再进行过继 T 细胞输注,可能不会增强体内免疫反应。