白细胞介素-2与诱导性杀伤细胞用于非小细胞肺癌的过继性免疫治疗：一项系统评价与荟萃分析
Adoptive immunotherapy with interleukin-2 & induced killer cells in non-small cell lung cancer: A systematic review & meta-analysis.
作者信息
Mi Denghai, Ren Weiwei, Yang Kehu
机构信息
Evidence Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road; The First Clinical Medicine College of Lanzhou University, 1 Donggang West Road; Gansu Provincial Second People's Hospital, 1 Hezheng West Road, Chengguan District, Lanzhou, Gansu, PR China.
Evidence Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road; The First Clinical Medicine College of Lanzhou University, 1 Donggang West Road; Gansu Provincial Cancer Hospital, 2 Xiaoxihu East Street, Qilihe District, Lanzhou, Gansu, PR China.
出版信息
Indian J Med Res. 2016 May;143(Supplement):S1-S10. doi: 10.4103/0971-5916.191738.
BACKGROUND & OBJECTIVES: The effectiveness of interleukin-2 (IL-2) and induced killer cells for non-small cell lung cancer (NSCLC) is controversial. This study evaluates the efficacy and safety of interleukin-2 and induced killer cells on NSCLC, so as to provide references for further clinical practice and research.
METHODS
Relevant randomized controlled trials (RCTs) were searched in Cochrane library (Issue 2, 2013), Web of Science (1980-March 2013), PubMed (1966-March 2013), China Knowledge Resource Integrated database (CNKI) (1994-March 2013), China Biology Medicine database (CBM) (1978-March 2013), VIP (1989-March 2013), and Wan Fang databases (1997-March 2013). There were no language restrictions. After independent quality assessment and data extraction by two authors, meta-analysis was conducted by RevMan 5.1 software.
RESULTS
Ten RCTs were included. Odds ratio (OR), 95% confidence intervals (CI), P value expressed as test group (interleukin-2 or induced killer cells combined chemotherapy) versus control group (chemotherapy alone), was 2.02 (1.24, 3.29; P=0.004) for disease control rate. Hazard ratios (HR) (95% CI; P value), expressed as test group (interleukin-2 or induced killer cells) versus control group, were 0.60 (0.46, 0.79; P=0.0003) for overall survival of postoperative treatment, and 0.77 (0.60, 0.99; P =0.04) for overall survival of combination with chemotherapy. Mean differences (MD) (95% CI; P value), expressed as test group (interleukin-2 or induced killer cells) versus control group (after treatment), were 11.32 (6.32, 16.33; P=0.00001) for NK cells, 11.79 (2.71, 20.86; P=0.01) for CD3+ cells, 14.63 (2.62, 26.64; P=0.02) for CD4+ cells, and -4.49 (-7.80, 1.18; P=0.008) for CD8+ cells.
INTERPRETATION & CONCLUSIONS: The meta-analysis showed that IL-2 or induced killer cells combination therapy was efficacious in treating NSCLC and improved overall survival. Further analysis of trials having adequate information and data need to be done to confirm these findings.
背景与目的
白细胞介素-2（IL-2）及诱导性杀伤细胞用于非小细胞肺癌（NSCLC）的疗效存在争议。本研究评估IL-2及诱导性杀伤细胞用于NSCLC的疗效及安全性，为进一步临床实践与研究提供参考。
方法
在Cochrane图书馆（2013年第2期）、科学引文索引（1980年至2013年3月）、PubMed（1966年至2013年3月）、中国知网（CNKI）（1994年至2013年3月）、中国生物医学文献数据库（CBM）（1978年至2013年3月）、维普资讯（VIP）（1989年至2013年3月）及万方数据库（1997年至2013年3月）中检索相关随机对照试验（RCT）。无语言限制。由两位作者独立进行质量评估及数据提取后，采用RevMan 5.1软件进行荟萃分析。
结果
纳入10项RCT。以试验组（IL-2或诱导性杀伤细胞联合化疗）对比对照组（单纯化疗），疾病控制率的比值比（OR）、95%置信区间（CI）、P值分别为2.02（1.24，3.29；P = 0.004）。以试验组（IL-2或诱导性杀伤细胞）对比对照组，术后治疗总生存的风险比（HR）（95%CI；P值）为0.60（0.46，0.79；P = 0.0003），联合化疗总生存的HR（95%CI；P值）为0.77（0.60，0.99；P = 0.04）。以试验组（IL-2或诱导性杀伤细胞）对比对照组（治疗后），自然杀伤细胞（NK细胞）的均数差（MD）（95%CI；P值）为11.32（6.32，16.33；P = 0.00001），CD3+细胞为11.79（2.71，20.86；P = 0.01），CD4+细胞为14.63（2.62，26.64；P = 0.02），CD8+细胞为 - 4.49（ - 7.80，1.18；P = 0.008）。
解读与结论
荟萃分析表明，IL-2或诱导性杀伤细胞联合疗法治疗NSCLC有效且可改善总生存。需对有充分信息及数据的试验做进一步分析以证实这些结果。
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