Abstract
BackgroundThe combination of dendritic cells (DCs) and cytokine-induced killer cells (CIKs) can induce the anti-tumor immune response and radiotherapy may promote the activity. We aimed to explore the feasibility of DCs/CIKs combined with thoracic radiotherapy (TRT) for patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC).MethodIn this study, patients with unresectable stage III/IV NSCLC and an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–2 and previously receiving two or more cycles of platinum-based doublet chemotherapy without disease progression received TRT plus DCs/CIKs or TRT alone until disease progression or unacceptable toxicity. The primary endpoint was median progression-free survival (mPFS). In treatment group, patients received four-cycle autologous DCs/CIKs infusion starting from the 6th fraction of irradiation.ResultsFrom Jan 13, 2012 to June 30, 2014, 82 patients were enrolled, with 21 patients in treatment group and 61 in control group. The mPFS in treatment group was longer than that in control group (330 days vs 233 days, hazard ratio 0.51, 95 % CI 0.27–1.0, P < 0.05), and the objective response rate (ORR) of treatment group (47.6 %) was significantly higher that of control group (24.6 %, P < 0.05). There was no significant difference in disease control rate (DCR) and median overall survival (mOS) between two groups (P > 0.05). The side effects in treatment group were mild and there was no treatment-related deaths.ConclusionThe combination of DCs/CIKs with TRT could be a feasible regimen in treating locally advanced or metastatic NSCLC patients. Further investigation of the regimen is warranted.
Highlights
Lung cancer is the most commonly diagnosed cancer worldwide (1.8 million, 13.0 % of the total), and a leading cause of cancer death (1.6 million, 19.4 % of the total) [1]
There was no significant difference in disease control rate (DCR) and median overall survival between two groups (P > 0.05)
0 complete response (CR), 10 partial response (PR), 9 stable disease (SD) and 2 progression disease (PD) were found in treatment group, and 0 CR, 15 PR, 39 SD and 7 PD were found in control group
Summary
Lung cancer is the most commonly diagnosed cancer worldwide (1.8 million, 13.0 % of the total), and a leading cause of cancer death (1.6 million, 19.4 % of the total) [1]. Patients with non-small cell lung cancer (NSCLC) account for more than 80 % of those with lung cancers [2]. Thoracic radiotherapy (TRT) plays an irreplaceable role in treating NSCLC patients, especially those with medically inoperable or locally advanced unresectable disease [4]. Accumulating evidences show that TRT may stimulate the anti-tumor immune response [5,6,7,8]. The combination of dendritic cells (DCs) and cytokine-induced killer cells (CIKs) can induce the anti-tumor immune response and radiotherapy may promote the activity. We aimed to explore the feasibility of DCs/CIKs combined with thoracic radiotherapy (TRT) for patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC)
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