吉西他滨联合过继性免疫疗法用于可切除胰腺癌的术后辅助治疗

Postoperative Adjuvant Therapy for Resectable Pancreatic Cancer With Gemcitabine and Adoptive Immunotherapy.

作者信息

Matsui Hiroto, Hazama Shoichi, Sakamoto Kazuhiko, Shindo Yoshitaro, Kanekiyo Shinsuke, Nakashima Masao, Matsukuma Satoshi, Tokuhisa Yoshihiro, Iida Michihisa, Suzuki Nobuaki, Yoshimura Kiyoshi, Takeda Shigeru, Ueno Tomio, Yoshino Shigefumi, Oka Masaaki, Nagano Hiroaki

机构信息

From the *Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine; †Department of Translational Research and Developmental Therapeutics Against Cancer, Yamaguchi University School of Medicine, Ube, Yamaguchi; ‡Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Japan, Tokyo; and §Oncology Center, Yamaguchi University Hospital, Ube, Japan.

出版信息

Pancreas. 2017 Sep;46(8):994-1002. doi: 10.1097/MPA.0000000000000880.

OBJECTIVES

We previously described adoptive immunotherapy (AIT) with cytotoxic T lymphocytes (CTLs) stimulated by the mucin 1 (MUC1)-expressing human pancreatic cancer cell line YPK-1 (MUC1-CTLs) and demonstrated that MUC1-CTLs might prevent liver metastasis. In the present study, we combined gemcitabine (GEM) and AIT for the treatment of pancreatic cancer.

METHODS

A total of 43 patients who underwent radical pancreatectomy received treatment with MUC1-CTLs and GEM. After surgery, MUC1-CTLs were induced and administered intravenously 3 times, and GEM administered according to the standard regimen for 6 months. The patients whose relative dose intensity of GEM was 50% or more and who received 2 or more MUC1-CTL treatments were used as the adequate treatment group (n = 21).

RESULTS

In the adequate treatment group, disease-free survival was 15.8 months, and overall survival was 24.7 months. Liver metastasis was found only in 7 patients (33%), and local recurrence occurred in 4 patients (19%). The independent prognostic factor of long-term disease-free survival on multivariate analysis was the average number of CTLs administered (P = 0.0133).

CONCLUSIONS

The combination therapy with AIT and GEM prevented liver metastasis and local recurrence. Moreover, the disease free-survival was improved in patients who received sufficient CTLs.