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接受免疫细胞治疗的胰腺癌患者的预后因素

Prognostic Factors for Pancreatic Cancer Patients Treated with Immune-cell Therapy.

作者信息

Makita Kaori, Kamigaki Takashi, Okada Sachiko, Matsuda Eriko, Ibe Hiroshi, Oguma Eri, Naitoh Keiko, Takimoto Rishu, Goto Shigenori

机构信息

Seta Clinic Group, Tokyo, Japan

Seta Clinic Group, Tokyo, Japan.

出版信息

Anticancer Res. 2018 Jul;38(7):4353-4360. doi: 10.21873/anticanres.12736.

Abstract

BACKGROUND/AIM: The past 17 years, immune-cell therapy has been administered to 990 patients with advanced or recurrent pancreatic adenocarcinoma and 50 patients with curatively resected pancreatic adenocarcinoma.

MATERIALS AND METHODS

The correlation between overall survival (OS) and various factors including sex, age, performance status (PS), distant metastasis, chemotherapy, radiotherapy, and type of immune-cell therapy were evaluated by univariate and multivariate analyses.

RESULTS

The median OS of advanced or recurrent pancreatic cancer was 5.8 months, and the prognosis was improved in pancreatic cancer patients who received immune-cell therapy with PS scores of 0-1 [hazard risk (HR)=0.56; 95% confidence interval (CI)=0.46-0.68; p<0.0001], chemotherapy (HR=0.68; 95%CI=0.54-0.87; p=0.002), or radiotherapy (HR=0.76; 95%CI=0.63-0.93; p=0.006). Multivariate analysis demonstrated that distant metastasis indicated a poor prognosis for pancreatic cancer patients that were administered immune-cell therapy (HR=1.62; 95%CI=1.37-1.93; p<0.0001). Additionally, the combined immune-cell therapy with αβ T cell and dendritic cell (DC) vaccine provided a survival benefit in advanced or recurrent pancreatic cancer patients (HR=0.69; 95%CI=0.57-0.83; p<0.0001).

CONCLUSION

A survival benefit could be potentially obtained with better PS by the combination of αβ T cell therapy, DC vaccine therapy, and chemotherapy at an early stage in pancreatic cancer.

摘要

背景/目的:在过去17年中,免疫细胞疗法已应用于990例晚期或复发性胰腺腺癌患者以及50例接受根治性切除的胰腺腺癌患者。

材料与方法

通过单因素和多因素分析评估总生存期(OS)与包括性别、年龄、体能状态(PS)、远处转移、化疗、放疗以及免疫细胞疗法类型等各种因素之间的相关性。

结果

晚期或复发性胰腺癌的中位总生存期为5.8个月,PS评分为0 - 1的接受免疫细胞疗法的胰腺癌患者预后得到改善[风险比(HR)=0.56;95%置信区间(CI)=0.46 - 0.68;p<0.0001],接受化疗的患者(HR=0.68;95%CI=0.54 - 0.87;p=0.002)以及接受放疗的患者(HR=0.76;95%CI=0.63 - 0.93;p=0.006)。多因素分析表明,远处转移提示接受免疫细胞疗法的胰腺癌患者预后不良(HR=1.62;95%CI=1.37 - 1.93;p<0.0001)。此外,αβT细胞与树突状细胞(DC)疫苗联合免疫细胞疗法为晚期或复发性胰腺癌患者带来了生存获益(HR=0.69;95%CI=0.57 - 0.83;p<0.0001)。

结论

在胰腺癌早期,通过αβT细胞疗法、DC疫苗疗法和化疗的联合应用,体能状态较好的患者可能获得生存获益。

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