过继性免疫治疗后胃癌患者总生存期延长。
Prolonged overall survival in gastric cancer patients after adoptive immunotherapy.
作者信息
Zhang Guo-Qing, Zhao Hong, Wu Jian-Yu, Li Jin-Yu, Yan Xiang, Wang Gang, Wu Liang-Liang, Zhang Xiao-Gang, Shao Yi, Wang Yu, Jiao Shun-Chang
机构信息
Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
出版信息
World J Gastroenterol. 2015 Mar 7;21(9):2777-85. doi: 10.3748/wjg.v21.i9.2777.
AIM
To assess the efficacy of immunotherapy with expanded activated autologous lymphocytes (EAALs) in gastric cancer.
METHODS
An observational study was designed to retrospectively analyze the clinical data of 84 gastric cancer patients, of whom 42 were treated by EAAL immunotherapy plus conventional treatment and another 42 only received conventional treatment (control group). EAALs were obtained by proliferation of peripheral blood mononuclear cells from patients followed by phenotype determination. Clinical data including age, gender, clinical stage, chemotherapeutic regimens, hospitalization, surgical, radiotherapy, and survival data were collected along with EAAL therapy details and side effects. Patients were followed and the relationship between treatment and overall survival (OS) data obtained for the immunotherapy and control groups were compared retrospectively. The safety of EAAL immunotherapy was also evaluated.
RESULTS
After in vitro culture and proliferation, the percentages of CD3+, CD3+CD8+, CD8+CD27+, CD8+CD28+, and CD3+CD16+/CD56+ cells increased remarkably (P < 0.05), while the percentages of CD3+CD4+, CD4+CD25+, and CD3-CD16+/CD56+ (natural killer cells) were overtly decreased (P < 0.05); no significant change was observed in CD4+CD25+CD127- cells (P = 0.448). Interestingly, OS in the immunotherapy group was significantly higher than that in the control group, with 27.0 and 13.9 mo obtained for the two groups, respectively (P = 0.028, HR = 0.573, 95%CI: 0.347-0.945). These findings indicated a 42.7% decrease in the risk of death. In addition, we found that clinical stage and application of EAAL immunotherapy were independent prognostic factors for gastric cancer patients. Indeed, the OS in stage IIIc and IV patients that had received surgery was prolonged after EAAL immunotherapy (P < 0.05). Importantly, in vitro induction and proliferation of EAAL were easy and biologically safe.
CONCLUSION
Overall, EAAL adoptive immunotherapy might prolong the OS in gastric cancer patients.
目的
评估扩增活化自体淋巴细胞（EAALs）免疫疗法对胃癌的疗效。
方法
设计一项观察性研究，回顾性分析84例胃癌患者的临床资料，其中42例接受EAAL免疫疗法加传统治疗，另外42例仅接受传统治疗（对照组）。通过患者外周血单个核细胞增殖获得EAALs，随后进行表型测定。收集包括年龄、性别、临床分期、化疗方案、住院情况、手术、放疗及生存数据等临床资料，以及EAAL治疗细节和副作用。对患者进行随访，回顾性比较免疫治疗组和对照组的治疗与总生存（OS）数据之间的关系。还评估了EAAL免疫疗法的安全性。
结果
体外培养和增殖后，CD3⁺、CD3⁺CD8⁺、CD8⁺CD27⁺、CD8⁺CD28⁺及CD3⁺CD16⁺/CD56⁺细胞百分比显著增加（P < 0.05），而CD3⁺CD4⁺、CD4⁺CD25⁺及CD3⁻CD16⁺/CD56⁺（自然杀伤细胞）百分比明显降低（P < 0.05）；CD4⁺CD25⁺CD127⁻细胞未见明显变化（P = 0.448）。有趣的是，免疫治疗组的OS显著高于对照组，两组分别为27.0个月和13.9个月（P = 0.028，HR = 0.573，95%CI：0.347 - 0.945）。这些结果表明死亡风险降低了42.7%。此外，我们发现临床分期和EAAL免疫疗法的应用是胃癌患者的独立预后因素。确实，接受手术的Ⅲc期和Ⅳ期患者在EAAL免疫治疗后OS延长（P < 0.05）。重要的是，EAAL的体外诱导和增殖简便且生物安全性良好。
结论
总体而言，EAAL过继性免疫疗法可能延长胃癌患者的OS。
Zotero 插件