Department of Oncology, First Teaching Hospital, Inner Mongolia Medical College, Huhhot, China.
Int J Clin Oncol. 2013 Aug;18(4):657-65. doi: 10.1007/s10147-012-0434-4. Epub 2012 Jul 31.
Dendritic cell (DC)-based and cytokine-induced killer cell (CIK)-based therapy can induce specific antitumor T-cell responses. This clinical pilot study examined the safety, the feasibility, and the outcome of tumor-specific immunotherapy for patients with advanced pancreatic adenocarcinoma.
Alpha-Gal epitopes were synthesised on pancreatic carcinoma cell membranes with α1,3-galactosyltransferase in vitro. Subsequently, the addition of natural human anti-Gal IgG to the processed membranes resulted in opsonization and effective phagocytosis by DCs, which were co-cultured with newly differentiated CIKs from bone marrow stem cells to generate tumor-specific immune responders ex vivo. Fourteen patients with inoperable stage III/IV pancreatic adenocarcinoma were enrolled in the study; the treatment procedure consisted of injections of DCs and CIKs.
Clinical observation showed that the procedure was safe and lacked serious side effects. Tests showed that 12 patients had strong positive delayed-type IV hypersensitivity to the autologous cancer cell lysate; robust systemic cytotoxicity elicited by interferon (IFN)γ expression by peripheral blood mononuclear cells; and significant increases in CD3+CD8+, CD3+CD45RO+, and CD3+CD56+ cells in peripheral blood lymphocytes after 3 injections. During the follow up, the percentages of CD3+CD8+, CD3+CD45RO+, and CD3+CD56+ cells returned to the normal range at 6 to 9 months after the third injection and IFNγ expression in the cells stayed at the higher level from the third injection to 24 months after the treatment.
This new tumor-specific immunotherapy is safe, feasible, and has great potential for pancreatic carcinoma treatment.
树突状细胞(DC)和细胞因子诱导的杀伤细胞(CIK)为基础的治疗可以诱导特异性抗肿瘤 T 细胞反应。这项临床初步研究旨在检验晚期胰腺腺癌患者肿瘤特异性免疫治疗的安全性、可行性和结果。
体外使用α1,3-半乳糖基转移酶在胰腺癌细胞膜上合成α-Gal 表位。随后,添加天然人抗-Gal IgG 到处理过的细胞膜上,导致 DC 的调理作用和有效吞噬,然后将新分化的 CIK 与骨髓干细胞共培养,从而在体外产生肿瘤特异性免疫反应细胞。本研究共纳入 14 例无法手术的 III/IV 期胰腺腺癌患者;治疗程序包括 DC 和 CIK 的注射。
临床观察显示该程序安全,无严重副作用。检测结果表明,12 例患者对自体肿瘤细胞裂解物具有强烈的阳性迟发型 IV 型超敏反应;外周血单个核细胞 IFNγ 表达诱导强烈的全身细胞毒性;3 次注射后,外周血淋巴细胞中 CD3+CD8+、CD3+CD45RO+和 CD3+CD56+细胞显著增加。随访发现,3 次注射后 6-9 个月,CD3+CD8+、CD3+CD45RO+和 CD3+CD56+细胞百分比恢复正常范围,细胞中 IFNγ 表达从第 3 次注射开始到治疗后 24 个月一直保持在较高水平。
这种新的肿瘤特异性免疫疗法安全、可行,对胰腺癌治疗具有很大的潜力。