Ding Xiao, Cao He, Chen Xiao, Jin Haofan, Liu Ziling, Wang Guanjun, Cai Lu, Li Dan, Niu Chao, Tian Huimin, Yang Lei, Zhao Yuguang, Li Wei, Cui Jiuwei
Cancer Center, the First Hospital of Jilin University, No. 71. Xinmin Street, Changchun, 130021, China.
Kosair Children's Hospital Research Institute, Department of Pediatrics, the University of Louisville, Louisville, KY, 40202, USA.
J Transl Med. 2015 May 13;13:158. doi: 10.1186/s12967-015-0514-0.
Small cell lung cancer (SCLC) relapses rapidly after the initial response to chemotherapy and shows drug-resistance. This study was to investigate the efficacy and safety of cellular immunotherapy (CIT) with autologous natural killer (NK), γδT, and cytokine-induced killer (CIK) cells as maintenance therapy for SCLC patients.
A pilot prospective cohort study was conducted with SCLC patients who had responded to initial chemotherapy. Patients elected to receive either CIT as maintenance therapy (study group), or to be followed-up without further treatment (control group). Progression-free survival (PFS), overall survival (OS), and adverse effects were investigated.
We recruited 58 patients (29 in each group). The patient characteristics of the 2 groups were well balanced. PFS was not significantly different between the groups, but OS was significantly longer in the study group than the control (20 vs. 11.5 months, P = 0.005; hazard ratio [HR], 0.434, 95 % confidence interval [CI], 0.236-0.797, P = 0.007). Among patients with limited-stage disease, there was no difference in PFS between the groups, but OS was longer in the study group compared to the control (26.5 vs. 11.8 months, P = 0.033; HR, 0.405, 95 % CI, 0.169-0.972, P = 0.043). Among patients with extensive-stage disease, both PFS and OS were longer in the study group than the control (5 vs. 2.7 months, P = 0.037; HR, 0.403, 95 % CI, 0.162-1.003, P = 0.051, and 14.5 vs. 9 months, P = 0.038; HR, 0.403, 95 % CI, 0.165-0.987, P = 0.047, respectively). No significant adverse reactions occurred in patients undergoing CIT.
CIT maintenance therapy in SCLC prolonged survival with only minimal side effects. Integrating CIT into current treatment may be a novel strategy for SCLC therapy, although further multi-center randomized studies are needed.
小细胞肺癌（SCLC）在对化疗产生初始反应后迅速复发并表现出耐药性。本研究旨在探讨采用自体自然杀伤（NK）细胞、γδT细胞和细胞因子诱导的杀伤（CIK）细胞进行细胞免疫治疗（CIT）作为SCLC患者维持治疗的疗效和安全性。
对初始化疗有反应的SCLC患者进行了一项前瞻性队列试点研究。患者选择接受CIT作为维持治疗（研究组），或不接受进一步治疗进行随访（对照组）。研究了无进展生存期（PFS）、总生存期（OS）和不良反应。
我们招募了58例患者（每组29例）。两组患者的特征均衡良好。两组之间的PFS无显著差异，但研究组的OS明显长于对照组（20个月对11.5个月，P = 0.005；风险比[HR]，0.434，95%置信区间[CI]，0.236 - 0.797，P = 0.007）。在局限期疾病患者中，两组之间的PFS无差异，但研究组的OS长于对照组（26.5个月对11.8个月，P = 0.033；HR，0.405，95% CI，0.169 - 0.972，P = 0.043）。在广泛期疾病患者中，研究组的PFS和OS均长于对照组（5个月对2.7个月，P = 0.037；HR，0.403，95% CI，0.162 - 1.003，P = 0.051，以及14.5个月对9个月，P = 0.038；HR，0.403，95% CI，0.165 - 0.987，P = 0.047）。接受CIT的患者未发生显著不良反应。
SCLC的CIT维持治疗可延长生存期，且副作用极小。将CIT纳入当前治疗可能是SCLC治疗的一种新策略，尽管还需要进一步的多中心随机研究。
