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异基因细胞免疫疗法联合化疗和靶向疗法治疗晚期转移性胰腺癌:一例报告

Allogeneic cell-based immunotherapy combined with chemotherapy and targeted therapy in advanced pancreatic cancer with metastases: A case report.

作者信息

Long Yanyan, Sun Qiong, Wu Jianyu, Wang Yu, Jiao Shunchang

机构信息

Department of Medical Oncology, Chinese PLA General Hospital, Beijing 100853, P.R. China ; Medical School of Nankai University, Tianjin 300071, P.R. China.

Department of Medical Oncology, Chinese PLA General Hospital, Beijing 100853, P.R. China.

出版信息

Oncol Lett. 2014 May;7(5):1594-1598. doi: 10.3892/ol.2014.1908. Epub 2014 Feb 24.

Abstract

Immunotherapy may be an effective and potentially less toxic treatment for cancer in addition to the traditional therapies. The current study presents a case of advanced pancreatic cancer that was treated with cell-based immunotherapy using expanded activated allogeneic lymphocytes (EAAL) with cluster of differentiation (CD)3(+) and CD8(+) cytotoxic T lymphocytes, and CD3(-) and CD56(+) natural killer cells as the major effector cells, together with chemotherapy and targeted agents. A 46-year-old female was diagnosed at the Chinese PLA General Hospital (Beijing, China) with stage IV pancreatic cancer with multiple metastases in October 2012. After receiving one cycle of chemotherapy plus nimotuzumab (Nimo), the patient received 14 infusions of EAAL, which was obtained from a related donor, combined with seven cycles of chemotherapy with gemcitabine plus oxaliplatin and targeted therapy with Nimo. The patient was followed up for eight months. One day prior to the cell infusion, targeted therapy was administered and 48 h following the cell infusion, chemotherapy was administered. Following this treatment, carbohydrate antigen 19-9 levels decreased from 4,136 U/ml to within the normal ranges, along with the significant regression of the lesions. Occasionally mild upset was observed following the EAAL transfusion. For the entire combined modality, grade II hematological and gastrointestinal toxicities plus grade I liver function damage and skin rash were identified. The present study demonstrated that combining allogeneic cell-based immunotherapy with conventional therapies is effective and safe, even in patients with end-stage pancreatic cancer. Therefore, this strategy is recommended for the treatment of similar cases.

摘要

除传统疗法外,免疫疗法可能是一种治疗癌症的有效且潜在毒性较小的方法。本研究报告了一例晚期胰腺癌病例,该患者接受了基于细胞的免疫疗法,使用扩增活化的同种异体淋巴细胞(EAAL),其中分化簇(CD)3(+)和CD8(+)细胞毒性T淋巴细胞以及CD3(-)和CD56(+)自然杀伤细胞作为主要效应细胞,并联合化疗和靶向药物进行治疗。一名46岁女性于2012年10月在中国人民解放军总医院(北京,中国)被诊断为IV期胰腺癌伴多发转移。在接受一个周期的化疗加尼妥珠单抗(Nimo)后,患者接受了14次从相关供体获取的EAAL输注,同时联合7个周期的吉西他滨加奥沙利铂化疗以及Nimo靶向治疗。对患者进行了8个月的随访。在细胞输注前一天给予靶向治疗,在细胞输注后48小时给予化疗。经过这种治疗,糖类抗原19-9水平从4136 U/ml降至正常范围,同时病变显著消退。EAAL输注后偶尔观察到轻度不适。对于整个联合治疗方案,确定有II级血液学和胃肠道毒性以及I级肝功能损害和皮疹。本研究表明,将同种异体细胞免疫疗法与传统疗法相结合是有效且安全的,即使对于晚期胰腺癌患者也是如此。因此,推荐这种策略用于治疗类似病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6b/3997695/5f45771f1b0b/OL-07-05-1594-g00.jpg

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