Abstract

Gastric and colorectal cancers (GC and CRC) have poor prognosis and are resistant to chemo- and/or radiotherapy. In the present study, the prophylactic effects of dendritic cell (DC) vaccination are evaluated on disease progression and clinical benefits in a group of 54 GC and CRC patients treated with DC immunotherapy combined with cytokine-induced killer (CIK) cells after surgery with or without chemo-radiotherapy. DCs were prepared from the mononuclear cells isolated from patients using IL-2/GM-CSF and loaded with tumor antigens; CIK cells were prepared by incubating peripheral blood lymphocytes with IL-2, IFN-γ, and CD3 antibodies. The DC/CIK therapy started 3 days after low-dose chemotherapy and was repeated 3–5 times in 2 weeks as one cycle with a total of 188.3±79.8×106 DCs and 58.8±22.3×108 CIK cells. Cytokine levels in patients' sera before and after treatments were measured and the follow-up was conducted for 98 months to determine disease-free survival (DFS) and overall survival (OS). The results demonstrate that all cytokines tested were elevated with significantly higher levels of IFN-γ and IL-12 in both GC and CRC cohorts of DC/CIK treated patients. By Cox regression analysis, DC/CIK therapy reduced the risk of post-operative disease progression (p<0.01) with an increased OS (<0.01). These results demonstrate that in addition to chemo- and/or radiotherapy, DC/CIK immunotherapy is a potential effective approach in the control of tumor growth for post-operative GC and CRC patients.

Highlights

  • Gastric cancer (GC) and colorectal cancer (CRC) are major malignant diseases of alimentary tract

  • Clinical benefits are evaluated in a group of 54 GC and CRC patients treated with dendritic cell (DC) immunotherapy combined with cytokine-induced killer (CIK) cells after surgery with or without chemo-radiotherapy

  • DC prepared from CRC patients were 87%-80% positive for DR/CD11C and 84%-71% positive for CD83 (Fig. 3A, B), and CIK cells from CRC patients were 75%-48% positive for CD3/CD8 and 41%-11% positive for CD3/CD56 respectively (Fig. 3C, D)

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Summary

Introduction

Gastric cancer (GC) and colorectal cancer (CRC) are major malignant diseases of alimentary tract. Patients with lymphoma [8,9], metastatic melanoma [10,11], colon cancer, and non-small cell lung cancer [12] showed that vaccination with tumor antigen-pulsed DCs, either isolated directly from blood or generated ex vivo from blood precursors, elicited antigen specific immune reaction and, in some cases, significant tumor responses. The anti-tumor responses triggered by DC/CIK therapy have been reported in a number of ex vivo [25,26,27,28,29] and in vivo [30] studies as well as in preliminary clinical trials in patients with nonHodgkin’s and Hodgkin’s lymphoma [31,32] and non-small cell lung cancer with few side effects [33]. The results demonstrate improved rates of DFS and OS with elevated levels of IFN-c and IL-12 in both GC and CRC cohorts of DC/CIK treated patients

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