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细胞免疫疗法联合化疗可改善胃癌患者的生存:一项荟萃分析。

Cellular immunotherapy plus chemotherapy ameliorates survival in gastric cancer patients: a meta-analysis.

机构信息

Department of General Surgery (Breast and Thyroid Surgery), Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, 568 Zhongxing Road, Shaoxing, 312000, Zhejiang, China.

Department of Nephrology, Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, 568 Zhongxing Road, Shaoxing, 312000, Zhejiang, China.

出版信息

Int J Clin Oncol. 2020 Oct;25(10):1747-1756. doi: 10.1007/s10147-020-01750-6. Epub 2020 Jul 30.

Abstract

The efficacy of cellular immunotherapy plus chemotherapy in treatment of gastric cancer (GC) remains inconsistent even controversial. Hence, we performed a meta-analysis to better comprehend the clinical value of cellular immunotherapy plus chemotherapy for GC patients. We searched PubMed, Embase and EBSCO databases to identify the studies evaluating the association of cellular immunotherapy plus chemotherapy and overall survival (OS) and/or disease-free survival (DFS) in patients with GC, and then combined relevant data into hazard ratios (HRs) for OS, DFS and clinicopathological features such as TNM stage, etc. with STATA 12.0. Eleven studies with 1244 patients were included in this meta-analysis. We found that cellular immunotherapy plus chemotherapy remarkably improved overall survival (OS) and diseases-free survival (DFS) as compared to the chemotherapy for GC patients. In subgroup analyses, pooled data showed that the combined therapy was significantly associated with better 3-year and 5-year survival rate, but not with 1-year survival rate of patients; the application of cellular immunotherapy based on either CIK or DC-CIK cells could enhance survival as well as NK, γδT and CIK cells-based immunotherapy. More importantly, the addition of cellular immunotherapy considerably improved OS and DFS only in patients with stage III rather than stage II. In addition, we also discovered that the combined therapy did not cause intolerable side effects to patients. Cellular immunotherapy plus chemotherapy ameliorates survival in GC, especially in patients with stage III, implicating that it is a valuable therapeutic strategy for these patients.

摘要

细胞免疫疗法联合化疗治疗胃癌的疗效仍存在不一致甚至有争议。因此,我们进行了一项荟萃分析,以更好地理解细胞免疫疗法联合化疗治疗胃癌患者的临床价值。我们检索了 PubMed、Embase 和 EBSCO 数据库,以确定评估细胞免疫疗法联合化疗与胃癌患者总生存期(OS)和/或无病生存期(DFS)相关性的研究,并将相关数据合并为 OS、DFS 和临床病理特征(如 TNM 分期等)的风险比(HRs),采用 STATA 12.0 进行分析。这项荟萃分析纳入了 11 项研究共 1244 例患者。结果发现,与化疗相比,细胞免疫疗法联合化疗显著改善了胃癌患者的总体生存率(OS)和无病生存率(DFS)。亚组分析显示,联合治疗与更好的 3 年和 5 年生存率显著相关,但与 1 年生存率无关;基于 CIK 或 DC-CIK 细胞的细胞免疫疗法的应用同样可以提高 NK、γδT 和 CIK 细胞免疫疗法的生存率。更重要的是,细胞免疫疗法的加入仅在 III 期患者中显著改善了 OS 和 DFS,而在 II 期患者中没有。此外,我们还发现联合治疗不会给患者带来不可耐受的副作用。细胞免疫疗法联合化疗可改善胃癌患者的生存状况,尤其是在 III 期患者中,这表明它是这些患者有价值的治疗策略。

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