Discipline of Surgery, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
J Immunother Cancer. 2023 Apr;11(4). doi: 10.1136/jitc-2023-006764.
The number of clinical studies evaluating the benefit of cytokine-induced killer cell (CIK) therapy, an adoptive immunotherapy, for colorectal cancer (CRC) is increasing. In many of these trials, CIK therapy was coadministered with conventional cancer therapy. The aim of this review is to systematically assess the available literature, in which the majority were only in Chinese, on CIK therapy for the management of CRC using meta-analysis and to identify parameters associated with successful CIK therapy implementation.
Prospective and retrospective clinical studies which compared CIK therapy to non-CIK therapy in patients with CRC were searched for electronically on MEDLINE, Embase, China National Knowledge Infrastructure, and Wanfang Data databases. The clinical endpoints of overall survival (OS), progression-free survival (PFS), OS and PFS rates, overall response rate (ORR), and toxicity were meta-analyzed using HR and relative ratio (RR), and subgroup analyses were performed using chi-square (χ) test and I-squared (I) statistics for study design, disease stage, cotherapy type, and timing of administration.
In total, 70 studies involving 6743 patients were analyzed. CIK therapy was favored over non-CIK therapy for OS (HR=0.59, 95% CI: 0.53 to 0.65), PFS (HR=0.55, 95% CI: 0.47 to 0.63), and ORR (RR=0.65, 95% CI: 0.57 to 0.74) without increasing toxicity (HR=0.59, 95% CI: 0.16 to 2.25). Subgroup analyses on OS and PFS by study design (randomized vs non-randomized study design), disease stage (Stage I-III vs Stage IV), cotreatment with dendritic cells (DCs) (CIK vs DC-CIK therapy), or timing of therapy administration (concurrent vs sequential with coadministered anticancer therapy) also showed that the clinical benefit of CIK therapy was robust in any subgroup analysis. Furthermore, cotreatment with DCs did not improve clinical outcomes over CIK therapy alone.
Compared with standard therapy, patients who received additional CIK cell therapy had favorable outcomes without increased toxicity, warranting further investigation into CIK therapy for the treatment of CRC.
评估细胞因子诱导的杀伤细胞（CIK）治疗作为一种过继免疫疗法对结直肠癌（CRC）益处的临床研究数量正在增加。在这些试验中，CIK 治疗通常与常规癌症治疗联合应用。本综述的目的是通过荟萃分析系统评估可用的文献，这些文献主要是中文文献，评估 CIK 治疗 CRC 的疗效，并确定与 CIK 治疗成功相关的参数。
检索 MEDLINE、Embase、中国国家知识基础设施（CNKI）和万方数据库，以电子方式搜索比较 CIK 治疗与 CRC 患者非 CIK 治疗的前瞻性和回顾性临床研究。使用 HR 和相对比值（RR）对总生存期（OS）、无进展生存期（PFS）、OS 和 PFS 率、总缓解率（ORR）和毒性的临床终点进行荟萃分析，并使用卡方（χ）检验和 I 平方（I）统计量进行亚组分析，以评估研究设计、疾病分期、联合治疗类型和治疗时间的影响。
共分析了 70 项涉及 6743 例患者的研究。与非 CIK 治疗相比，CIK 治疗在 OS（HR=0.59，95%CI：0.53 至 0.65）、PFS（HR=0.55，95%CI：0.47 至 0.63）和 ORR（RR=0.65，95%CI：0.57 至 0.74）方面更具优势，同时不增加毒性（HR=0.59，95%CI：0.16 至 2.25）。按研究设计（随机与非随机研究设计）、疾病分期（I-III 期与 IV 期）、联合使用树突状细胞（DC）（CIK 与 DC-CIK 治疗）或治疗时间（与联合抗癌治疗同时或序贯应用）进行的 OS 和 PFS 亚组分析也表明，CIK 治疗的临床获益在任何亚组分析中均具有稳健性。此外，与单独使用 CIK 治疗相比，联合使用 DC 并不能改善临床结局。
与标准治疗相比，接受额外 CIK 细胞治疗的患者具有更好的疗效，且无毒性增加，这支持进一步研究 CIK 治疗 CRC。
Zotero 插件
