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采用 DC/CIK 过继性 T 细胞免疫疗法联合化疗治疗晚期非小细胞肺癌(NSCLC)患者:一项前瞻性基于患者偏好的研究(PPPS)。

Combination of DC/CIK adoptive T cell immunotherapy with chemotherapy in advanced non-small-cell lung cancer (NSCLC) patients: a prospective patients' preference-based study (PPPS).

机构信息

Department of Medical Oncology, Beijing Key Laboratory for Therapeutic Cancer Vaccines, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Capital Medical University, 10 Tieyi Rd, Beijing, 100038, China.

Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA.

出版信息

Clin Transl Oncol. 2019 Jun;21(6):721-728. doi: 10.1007/s12094-018-1968-3. Epub 2018 Oct 29.

Abstract

BACKGROUND

Advanced non-small cell lung cancer (NSCLC) has remained challenging to treat effectively. This study aimed to investigate the clinical effects and safety of immunotherapy with dendritic cells and cytokine-induced killer cells (DC-CIK) administered with chemotherapy (CT) in this malignancy.

METHODS

We have developed a new clinical trial design termed as the prospective patient's preference-based study (PPPS). Consecutive patients (n = 135) with advanced NSCLC were treated with DC-CIK administered with CT or mono-therapy (CT or DC-CIK alone).

RESULTS

For all the patients, the median PFS was 5.7 months and the median OS was 17.5 months. The 1-year PFS and OS rates were 29.4% and 58.2%, respectively. The 1-year PFS and OS rates for DC-CIK plus CT were significantly higher than that in the group of patients who received DC-CIK alone and CT alone (P < 0.05). The number of adoptively infused DC-CIK cells was associated with clinical efficacy. After adjusting for competing risk factors, DC-CIK combined with CT and infused number of CIKs remained independent predictors of PFS and OS. Phenotypic analysis of peripheral blood mononuclear cells showed that CD8+CD28+, and CD8+CD28- T cells, changed significantly in all groups (P < 0.01). The CD3+ T cells increased in the chemotherapy plus immunotherapy and the immunotherapy alone group (P < 0.01), while CD3-CD16+CD56 T cells decreased in the chemotherapy plus immunotherapy and the immunotherapy alone group (P < 0.01).

CONCLUSIONS

DC-CIK combined with chemotherapy administration resulted in numerically superior PFS and OS compared with monotherapy in advanced NSCLC.

摘要

背景

晚期非小细胞肺癌(NSCLC)的治疗仍然具有挑战性。本研究旨在探讨树突状细胞和细胞因子诱导的杀伤细胞(DC-CIK)联合化疗(CT)治疗这种恶性肿瘤的临床疗效和安全性。

方法

我们设计了一种新的临床试验设计,称为前瞻性患者偏好研究(PPPS)。连续入组的 135 例晚期 NSCLC 患者接受 DC-CIK 联合 CT 或单药治疗(CT 或 DC-CIK 单药)。

结果

所有患者的中位无进展生存期(PFS)为 5.7 个月,中位总生存期(OS)为 17.5 个月。1 年 PFS 和 OS 率分别为 29.4%和 58.2%。与 DC-CIK 单药组和 CT 单药组相比,DC-CIK 联合 CT 组的 1 年 PFS 和 OS 率显著提高(P<0.05)。回输的 DC-CIK 细胞数量与临床疗效相关。调整竞争风险因素后,DC-CIK 联合 CT 治疗和回输 CIK 细胞数量仍然是 PFS 和 OS 的独立预测因素。外周血单个核细胞表型分析显示,所有组的 CD8+CD28+和 CD8+CD28-T 细胞均发生显著变化(P<0.01)。化疗联合免疫治疗和免疫治疗组 CD3+T 细胞增加(P<0.01),而化疗联合免疫治疗和免疫治疗组 CD3-CD16+CD56 T 细胞减少(P<0.01)。

结论

与单药治疗相比,DC-CIK 联合化疗可改善晚期 NSCLC 的 PFS 和 OS。

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