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局部区域治疗联合同种异体 γδ T 细胞过继转移治疗晚期肝细胞癌和肝内胆管细胞癌的临床安全性和疗效。

Clinical Safety and Efficacy of Locoregional Therapy Combined with Adoptive Transfer of Allogeneic γδ T Cells for Advanced Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.

机构信息

Medical College of Guangxi University, Nanning, China.

Fuda Cancer Hospital of Jinan University, Guangzhou, China.

出版信息

J Vasc Interv Radiol. 2022 Jan;33(1):19-27.e3. doi: 10.1016/j.jvir.2021.09.012. Epub 2021 Sep 29.

DOI:10.1016/j.jvir.2021.09.012
PMID:34600129
Abstract

PURPOSE

To investigate the safety and efficacy of locoregional therapy plus adoptive transfer of allogeneic gamma delta (γδ) T cells for patients with hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).

METHODS

Thirty patients with HCC and 29 patients with ICC were randomly assigned to receive locoregional therapy (HCC, Group A, n = 15; ICC, Group C, n = 15) or locoregional therapy plus γδ T cell therapy (HCC, Group B, n = 15; ICC, Group D, n = 14). Groups A and C only received locoregional ablation (cryoablation or irreversible electroporation), whereas Groups B and D received locoregional therapy followed by adoptive transfer of allogeneic γδ T cells. The primary endpoints were safety, distant progression-free survival (PFS), local PFS, and overall survival (OS).

RESULTS

The median distant PFS was significantly longer in the combined treatment groups than the locoregional treatment groups (HCC: 8 vs 4 months, P = .04; ICC: 8 vs 4 months, P = .021). There was no significant difference in local PFS between the 2 treatment modalities. Patients with HCC in the combined treatment group had a longer OS (median OS: 13 vs 8 months, P = .029). However, there was no significant difference in OS in patients with ICC between the 2 treatment modalities (median OS: 9.5 vs 8 months, P = .546). All adverse events were manageable with no significant difference in incidence between groups.

CONCLUSIONS

The novel combination of locoregional ablation with adoptive transfer of allogeneic γδ cells was safe, with encouraging clinical efficacy against HCC and ICC.

摘要

目的

研究局部治疗联合同种异体γδ(γδ)T 细胞过继转移治疗肝细胞癌(HCC)和肝内胆管细胞癌(ICC)的安全性和有效性。

方法

30 例 HCC 患者和 29 例 ICC 患者被随机分为局部治疗组(HCC,A 组,n=15;ICC,C 组,n=15)或局部治疗联合γδ T 细胞治疗组(HCC,B 组,n=15;ICC,D 组,n=14)。A 组和 C 组仅接受局部消融(冷冻消融或不可逆电穿孔),B 组和 D 组在接受局部治疗后接受同种异体γδ T 细胞过继转移。主要终点是安全性、远处无进展生存期(PFS)、局部 PFS 和总生存期(OS)。

结果

联合治疗组的中位远处 PFS 明显长于局部治疗组(HCC:8 个月比 4 个月,P=0.04;ICC:8 个月比 4 个月,P=0.021)。两种治疗方法在局部 PFS 方面无显著差异。联合治疗组 HCC 患者的 OS 更长(中位 OS:13 个月比 8 个月,P=0.029)。然而,两种治疗方法在 ICC 患者的 OS 方面无显著差异(中位 OS:9.5 个月比 8 个月,P=0.546)。所有不良事件均可控制,两组间发生率无显著差异。

结论

局部消融联合同种异体γδ 细胞过继转移的新组合是安全的,对 HCC 和 ICC 具有令人鼓舞的临床疗效。

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