Zhang Luping, Xu Yanmei, Shen Jie, He Feng, Zhang Dan, Chen Zhengtang, Duan Yuzhong, Sun Jianguo
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
Oncology Department, Leshan People's Hospital, Sichuan, 614000, China.
Radiat Oncol. 2016 Apr 21;11:60. doi: 10.1186/s13014-016-0635-5.
The combination of dendritic cells (DCs) and cytokine-induced killer cells (CIKs) can induce the anti-tumor immune response and radiotherapy may promote the activity. We aimed to explore the feasibility of DCs/CIKs combined with thoracic radiotherapy (TRT) for patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC).
In this study, patients with unresectable stage III/IV NSCLC and an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-2 and previously receiving two or more cycles of platinum-based doublet chemotherapy without disease progression received TRT plus DCs/CIKs or TRT alone until disease progression or unacceptable toxicity. The primary endpoint was median progression-free survival (mPFS). In treatment group, patients received four-cycle autologous DCs/CIKs infusion starting from the 6(th) fraction of irradiation.
From Jan 13, 2012 to June 30, 2014, 82 patients were enrolled, with 21 patients in treatment group and 61 in control group. The mPFS in treatment group was longer than that in control group (330 days vs 233 days, hazard ratio 0.51, 95 % CI 0.27-1.0, P < 0.05), and the objective response rate (ORR) of treatment group (47.6 %) was significantly higher that of control group (24.6 %, P < 0.05). There was no significant difference in disease control rate (DCR) and median overall survival (mOS) between two groups (P > 0.05). The side effects in treatment group were mild and there was no treatment-related deaths.
The combination of DCs/CIKs with TRT could be a feasible regimen in treating locally advanced or metastatic NSCLC patients. Further investigation of the regimen is warranted.
树突状细胞（DCs）与细胞因子诱导的杀伤细胞（CIKs）联合可诱导抗肿瘤免疫反应，放疗可能会增强其活性。我们旨在探讨DCs/CIKs联合胸部放疗（TRT）用于局部晚期或转移性非小细胞肺癌（NSCLC）患者的可行性。
在本研究中，不可切除的Ⅲ/Ⅳ期NSCLC患者，东部肿瘤协作组体能状态（ECOG PS）为0 - 2，且之前接受过两个或更多周期含铂双药化疗且无疾病进展，接受TRT联合DCs/CIKs或单纯TRT治疗，直至疾病进展或出现不可接受的毒性反应。主要终点为中位无进展生存期（mPFS）。治疗组患者从放疗第6次开始接受4周期自体DCs/CIKs输注。
2012年1月13日至2014年6月30日，共纳入82例患者，治疗组21例，对照组61例。治疗组的mPFS长于对照组（330天对233天，风险比0.51，95%CI 0.27 - 1.0，P < 0.05），治疗组的客观缓解率（ORR）显著高于对照组（47.6%对24.6%，P < 0.05）。两组间疾病控制率（DCR）和中位总生存期（mOS）无显著差异（P > 0.05）。治疗组的副作用较轻，且无治疗相关死亡。
DCs/CIKs联合TRT可能是治疗局部晚期或转移性NSCLC患者的一种可行方案。有必要对该方案进行进一步研究。
