Departments of *Immunotherapy ‡Urology §Hematology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou †Department of Oncology, Affiliated Hospital of Xinxiang Medical College, Xinxiang, China.
J Immunother. 2014 Jan;37(1):43-50. doi: 10.1097/CJI.0000000000000005.
Metastatic renal cell carcinoma (MRCC) is one of the malignancies that are sensitive to immunotherapy. However, the underlying immune inhibitory factors such as myeloid-derived suppressor cells (MDSCs) might restrain the efficacy of immunotherapy. The present study investigates the clinical efficacy of cytokine-induced killer (CIK) cell therapy in patients with MRCC and explores whether the levels of peripheral MDSCs are associated with the prognosis of patients receiving this therapy. Twenty-nine patients with measurable MRCC were treated with an adoptive transfer of autologous CIK cells, followed by 5 consecutive days of interleukin-2 administration. The tumor response and 1-year survival were observed. The proportion of MDSCs in the peripheral blood was detected, and the correlation of MDSCs with prognosis was analyzed. Of 29 evaluable patients, no complete responses were seen; 4 patients exhibited a partial response (13.8%), 18 patients displayed stable disease (62.1%), and 7 patients showed progressive disease (24.1%). Twenty patients (69.0%) were alive 14.8-41.4 months at the time of the last follow-up (median follow-up=20.2 mo). The 1-year survival was 82.8% (24/29). Peripheral blood MDSCs were elevated in almost all MRCC patients and decreased after CIK-cell infusion. Subgroup analysis indicated that patients with a relatively low proportion of MDSCs exhibited prolonged survival. In conclusion, our data suggest that transfusion of autologous CIK cells can induce regression of MRCC, and MDSCs can serve as a potential marker for the prognosis of patients receiving a CIK-based therapy.
转移性肾细胞癌 (MRCC) 是对免疫疗法敏感的恶性肿瘤之一。然而,髓系来源的抑制细胞 (MDSCs) 等潜在的免疫抑制因子可能会抑制免疫疗法的疗效。本研究探讨了细胞因子诱导的杀伤 (CIK) 细胞疗法在 MRCC 患者中的临床疗效,并探讨了外周血 MDSCs 水平是否与接受该疗法治疗的患者的预后相关。29 例可测量的 MRCC 患者接受了自体 CIK 细胞过继转移治疗,随后连续 5 天给予白细胞介素-2 治疗。观察肿瘤反应和 1 年生存率。检测外周血 MDSCs 的比例,并分析 MDSCs 与预后的相关性。在 29 例可评估的患者中,未见完全缓解;4 例部分缓解(13.8%),18 例疾病稳定(62.1%),7 例疾病进展(24.1%)。20 例(69.0%)患者在最后一次随访时存活 14.8-41.4 个月(中位随访时间=20.2 个月)。1 年生存率为 82.8%(24/29)。几乎所有 MRCC 患者的外周血 MDSCs 升高,CIK 细胞输注后降低。亚组分析表明,MDSCs 比例相对较低的患者生存时间延长。综上所述,我们的数据表明,自体 CIK 细胞输注可诱导 MRCC 消退,MDSCs 可作为接受 CIK 治疗的患者预后的潜在标志物。