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一项关于自体树突状细胞、细胞因子诱导的杀伤细胞与化疗联合应用于晚期非小细胞肺癌患者疗效的前瞻性研究。

A prospective study of the efficacy of a combination of autologous dendritic cells, cytokine-induced killer cells, and chemotherapy in advanced non-small cell lung cancer patients.

作者信息

Zhong Runbo, Han Baohui, Zhong Hua

机构信息

Department of Pulmonary Disease, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241, Huaihai Road (W), Shanghai, People's Republic of China.

出版信息

Tumour Biol. 2014 Feb;35(2):987-94. doi: 10.1007/s13277-013-1132-1. Epub 2013 Sep 5.

Abstract

Dendritic cells (DC) play a crucial role in the induction of an effective antitumor immune response. Cytokine-induced killer (CIK) cells, a subset of T lymphocytes, have the capacity to eliminate cancer cells. This study was to evaluate the correlation between the frequency of DC/CIK immunotherapies following regular chemotherapy, the time-to-progression (TTP), and overall survival (OS) of advanced non-small lung cancer patients. Sixty patients with IIIB-IV non-small-cell lung carcinoma (NSCLC) were enrolled from August 2007 to December 2009 and were randomized into two groups. All 60 patients received four courses of navelbine-platinum (NP) chemotherapy. In one group, 30 patients were treated with adoptive autologous DC/CIK cell transfusion twice every 30 days. In the other group, the patients received immunotherapies more than twice every 30 days. The adverse effects, TTP, and OS were evaluated between the two groups. Median survival time of all 60 patients was 13.80 months. The 1-, 2-, and 3-year overall survival rates were 60.0, 21.7, and 15.0 %, respectively. The 1-, 2-, and 3-year overall survival rates of patients receiving more than two immunotherapies were 63.3, 30.0, and 23.3 %, and the rates of those receiving two immunotherapies were 56.7, 13.3, and 6.7 %, respectively. The difference between the two groups was statistically significant (P = 0.037). Compared with patients in the fewer immunotherapies group, TTP in the group receiving more immunotherapies significantly prolonged, with the median improving from 6.2 months (95 % CI, 5.35-9.24) to 7.3 months (95 % CI, 5.45-6.95; P = 0.034). The adverse effects of chemoimmunotherapy were tolerable. Advanced NSCLC patients can benefit from the combination of DC/CIK immunotherapies following conventional chemotherapy. More than two immunotherapies improved TTP and OS of those patients in this study.

摘要

树突状细胞(DC)在诱导有效的抗肿瘤免疫反应中起着关键作用。细胞因子诱导的杀伤细胞(CIK)是T淋巴细胞的一个亚群,具有清除癌细胞的能力。本研究旨在评估晚期非小细胞肺癌患者在常规化疗后进行DC/CIK免疫治疗的频率、疾病进展时间(TTP)和总生存期(OS)之间的相关性。2007年8月至2009年12月,招募了60例IIIB-IV期非小细胞肺癌(NSCLC)患者,并随机分为两组。所有60例患者均接受了四个疗程的去甲长春花碱-顺铂(NP)化疗。其中一组30例患者每30天接受两次自体DC/CIK细胞过继性输血治疗。另一组患者每30天接受两次以上的免疫治疗。评估两组之间的不良反应、TTP和OS。60例患者的中位生存时间为13.80个月。1年、2年和3年总生存率分别为60.0%、21.7%和15.0%。接受两次以上免疫治疗的患者1年、2年和3年总生存率分别为63.3%、30.0%和23.3%,接受两次免疫治疗的患者的相应生存率分别为56.7%、13.3%和6.7%。两组之间的差异具有统计学意义(P = 0.037)。与免疫治疗次数较少组的患者相比,接受更多免疫治疗组的TTP显著延长,中位时间从6.2个月(95%CI,5.35-9.24)提高到7.3个月(95%CI,5.45-6.95;P = 0.034)。化疗免疫治疗的不良反应是可耐受的。晚期NSCLC患者可从常规化疗后联合DC/CIK免疫治疗中获益。在本研究中,两次以上的免疫治疗改善了这些患者的TTP和OS。

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