Wang Xiang, Tang Song, Cui Xiang, Yang Jinwei, Geng Chunyu, Chen Cong, Zhou Ning, Li Yumin
Lanzhou University Second Hospital Key Laboratory of Digestive System Tumors of Gansu Province The First People's Hospital of Lanzhou City, Lanzhou Medicine School of Kunming University, China.
Medicine (Baltimore). 2018 Sep;97(36):e12230. doi: 10.1097/MD.0000000000012230.
Immunotherapy is emerging as a new treatment strategy for gastric cancer(GC). However, the efficacy and safety of this technique remain unclear. This meta-analysis aimed to assess the effect of cytokine-induced killer cell (CIK)/dendritic cell-cytokine-induced killer cell (DC-CIK) treatment for GC after surgery.
Hazard ratio (HR), overall survival (OS) rates, and disease-free survival (DFS) rates were calculated using a Mantel-Haenszel (M-H) fixed-effects model (FEM), and results were displayed using forest plots. Publication bias was assessed by Begg test, and data were presented using funnel plots. Date robustness was assessed by the trim and fill method. Descriptive analysis was performed on T lymphocytes and adverse effects.
In total, 9 trials, including 1216 patients, were eligible for inclusion in this meta-analysis. Compared with the control group, the HR for OS was 0.712 (95% confidence interval [CI] 0.594-0.854) and 0.66 (95% CI 0.546-0.797) for overall (DFS). The risk ratio (RR) of the 3 and 5-year OS rate was 1.29 (95% CI 1.15-1.46) and 1.73 (95% CI 1.36-2.19), respectively. The RR for the 3 and 5-year DFS rate 1.40 (95% CI 1.19-1.65) and 2.10 (95% CI1.53-2.87), respectively. The proportion of patients who were CD3+, CD4+, and CD4+/CD8+ increased in the cellular therapy groups. No fatal adverse reactions were noted.
Chemotherapy combined with CIK/DC-CIK therapy after surgery resulted in low HR, and significantly increasing OS rates, DFS rates, and T-lymphocyte responses in patients with GC.
免疫疗法正在成为胃癌（GC）的一种新治疗策略。然而，该技术的疗效和安全性仍不明确。本荟萃分析旨在评估细胞因子诱导的杀伤细胞（CIK）/树突状细胞-细胞因子诱导的杀伤细胞（DC-CIK）治疗对胃癌术后的效果。
采用Mantel-Haenszel（M-H）固定效应模型（FEM）计算风险比（HR）、总生存率（OS）和无病生存率（DFS），结果用森林图展示。采用Begg检验评估发表偏倚，用漏斗图呈现数据。用修剪和填充法评估数据稳健性。对T淋巴细胞和不良反应进行描述性分析。
本荟萃分析共纳入9项试验，包括1216例患者。与对照组相比，OS的HR为0.712（95%置信区间[CI]0.594-0.854），总体DFS的HR为0.66（95%CI0.546-0.797）。3年和5年OS率的风险比（RR）分别为1.29（95%CI1.15-1.46）和1.73（95%CI1.36-2.19）。3年和5年DFS率的RR分别为1.40（95%CI1.19-1.65）和2.10（95%CI1.53-2.87）。细胞治疗组中CD3 +、CD4 +和CD4 +/CD8 +患者的比例增加。未观察到致命不良反应。
术后化疗联合CIK/DC-CIK治疗导致GC患者的HR较低，并显著提高了OS率、DFS率和T淋巴细胞反应。
