Effective activity of cytokine induced killer cells against hepatocellular carcinoma including tumor-initiating cells.

Tumor-initiating cells (TICs) are a subpopulation of chemoresistant tumor cells that have been shown to cause tumor recurrence. Targeting and eliminating of TICs are therefore priorities for the development of new therapeutic paradigms. Much promise lies in adoptive immunotherapy. Cytokine-induced killer (CIK) cells are heterogeneous ex vivo-expanded T lymphocytes, with a mixed T-NK phenotype. It represents a realistic new option in the field of hepatocellular carcinoma (HCC) immunotherapy. In the very recent years, large clinical trials demonstrated that CIK cells could improve the Progression Free Survival (PFS) and Overall Survival (OS) in patients with HCC. By the same time, several studies reported that CIK cells were capable of clearing cells with stemness features in lymphoma, melanoma, bone and soft-tissue sarcomas. Based on the findings above mentioned, we hypothesized that CIK cells could eliminate the tumor-initiating cells, improving the PFS and OS of patients with HCC when combined with radiofrequency ablation (RFA) or transcatheter arterial chemoembolization (TACE).