Risk of HCC recurrence with cellular immunotherapy following radiofrequency ablation.

Abstract

3031 Background: Although radiofrequency ablation (RFA) has brought promising therapeutic outcome in hepatocellular carcinoma (HCC) treatment, the curative rate was compromised by high recurrence and metastasis after RFA. Immunosupression in patients with HCC is an important factor leading to its recurrence and metastasis. This study was designed to observe the efficiency and safety of application of cellular immunotherapy (CIT) after RFA for HCC patients. Methods: Sixty-two patients with HCC who were treated with radical RFA were divided into two groups: RFA alone (32 patients) and RFA/CIT (30 patients). Autologous mononuclear cells were collected from the peripheral blood and separated by apheresis, and then induced into natural killer cells, γδT cells, cytokine-induced killer cells. These cells were identified by flow cytometry with their specific antibodies and then were infused intravenously to RFA/CIT patients for 3 or 6 courses. The tumor recurrent status of these patients was evaluated with computed tomography (CT) every 3 months after RFA. Progression-free survival (PFS), liver function, viral load, and adverse effects were examined. Results: The median PFS in RFA group was 12.0 (9.1-14.8) months while median PFS in RFA/CIT group has not yet been reached. It indicated that sequential RFA/CIT significantly reduced the risk of HCC recurrence [hazard ratio (HR) = 0.136]. In RFA/CIT group, six courses had better survival prognosis than three courses (P <0.05). Viral load of hepatitis C decreased in two of three patients without antiviral therapy in RFA/CIT group, but was increased in RFA alone group. The RFA/CIT group maintained the hepatic function at the level before CIT. The hepatic function in 28.1% (9/32 cases) patients in RFA group was deteriorated. Only one developed fever (38.5 °C) after one infusion and recovered 2 hours later. Otherwise, there was no toxic effect in the RFA/CIT group. Conclusions: These preliminary results suggested that combination of sequential CIT with RFA for HCC patients was efficient and safe, and may be helpful in the prevention of the recurrence for the patients with HCC after RFA. It also suggested that the CIT may reduce the risk of recurrence by dual effects of anti-tumor and anti-virus.