Abstract
AimThe aim of this study was to systemically evaluate the therapeutic efficacy of cytokine-induced killer (CIK) cells for the treatment of non-small cell lung cancer.Materials and MethodsA computerized search of randomized controlled trials for CIK cell-based therapy was performed. The overall survival, clinical response rate, immunological assessment and side effects were evaluated.ResultsOverall, 17 randomized controlled trials of non-small cell lung cancer (NSCLC) with a total of 1172 patients were included in the present analysis. Our study showed that the CIK cell therapy significantly improved the objective response rate and overall survival compared to the non-CIK cell-treated group. After CIK combined therapy, we observed substantially increased percentages of CD3+, CD4+, CD4+CD8+, CD3+CD56+ and NK cells, whereas significant decreases were noted in the percentage of CD8+ and regulatory T cell (Treg) subgroups. A significant increase in Ag-NORs was observed in the CIK-treated patient group (p = 0.00001), whereas carcinoembryonic antigen (CEA) was more likely to be reduced to a normal level after CIK treatment (p = 0.0008). Of the possible major side effects, only the incidence of fever in the CIK group was significantly higher compared to the group that received chemotherapy alone.ConclusionThe CIK cell combined therapy demonstrated significant superiority in the overall survival, clinical response rate, and T lymphocytes responses and did not present any evidence of major adverse events in patients with NSCLC.
Highlights
Lung cancer is the leading cause of cancer-related mortality worldwide [1]
The final 17 articles were included in the metaanalysis with randomized controlled trials (RCT) of cytokine-induced killer (CIK) cell-based therapy for the treatment of non-small cell lung cancer (NSCLC) (Figure 1, see the checklist S1)
Our meta-analysis evaluated a variety of T-cell subgroups, and the differences in the cytokines used for immunotherapy, and we found that the results were consistent with the clinical therapeutic outcomes, such as the overall survival and clinical response
Summary
Lung cancer is the leading cause of cancer-related mortality worldwide [1]. According to the 2012 Chinese cancer registration annual report, more than 3 million new cases of lung cancer will be diagnosed every year, and the approximately 2.7 million deaths from lung cancer will account for 13% of allmortalities. There is no doubt that the incidence and mortality of lung cancer are far too prevalent [2]. In patients with advanced lung disease, 1-year survival rates are typically 35%, and 2-year survival rates were shown to approach 15%-20% in recent studies [3]. The 5year overall survival rate of localized cancer is 15.9%, and only half of extended-stage patients have a 3.7% chance of surviving 5 years [4]. Most NSCLC patients have locally advanced or metastatic cancer at stage IIIB-IV at the time of diagnosis, leaving only palliative therapeutic options. Based on the existing clinical data, chemotherapy appears to have limited benefits and disappointed prognoses [5]
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