Autologous transplantation of cytokine-induced killer cells as an adjuvant therapy for hepatocellular carcinoma in Asia: an update meta-analysis and systematic review.
Autologous transplantation of cytokine-induced killer cells as an adjuvant therapy for hepatocellular carcinoma in Asia: an update meta-analysis and systematic review.
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细胞因子诱导的杀伤细胞自体移植作为亚洲肝细胞癌的辅助治疗：最新荟萃分析和系统评价
DOI：
10.18632/oncotarget.15454
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发表时间：
2017-05-09
期刊：
影响因子：
--
通讯作者：
Wu XY
中科院分区：
文献类型：
--
作者：
Cai XR;Li X;Lin JX;Wang TT;Dong M;Chen ZH;Jia CC;Hong YF;Lin Q;Wu XY
背景肝细胞癌（HCC）治疗后复发率高是其主要问题。细胞因子诱导的杀伤细胞（CIK）治疗在HCC患者中得到了广泛研究。然而，CIK治疗的价值存在争议。进行了一项荟萃分析，以调查HCC患者中侵入性治疗后辅助CIK的疗效。方法通过网络检索CIK序贯治疗肝癌的相关文献。将无复发生存期（RFS）、无进展生存期（PFS）和总生存期（OS）设定为主要终点。完成了总体和亚组分析。结果共纳入12个临床试验，共1,387例患者。合并分析显示CIK组的RFS、PFS和OS显著改善（RFS HR 0.56，95% CI 0.47-0.67，p<0.00001; PFS HR 0.53，95% CI 0.40-0.69，p<0.00001; OS HR 0.59，95% CI 0.46-0.77，p<0.0001）。在CIK治疗后，CD 4 + T细胞的比例显著增加，而CD 8 + T细胞显著降低（分别为WMD 4.07，95%CI 2.58-5.56，p<0.00001; WMD-2.84，95%CI-4.67至-1.01，p=0.002）。CIK组与非CIK组的不良事件发生率无显著性差异。结论常规侵袭性治疗联合CIK治疗可改善HCC患者的预后，尤其是RFS和PFS，且副作用轻微。优化患者选择是今后研究的方向。
Background High recurrence rate after curative treatment is the major problem for hepatocellular carcinoma (HCC). Cytokine-induced killer cells (CIKs) therapy was extensively studied among HCC patients. However, the value of CIKs therapy was controversial. A meta-analysis was performed to investigate the efficacy of adjuvant CIKs after invasive treatments among HCC patients. Methods We searched online for literatures studying sequential CIKs therapy for HCC patients. Recurrence-free survival (RFS), progress-free survival (PFS) and overall survival (OS) were set as the main endpoints. Both overall and subgroup analysis were accomplished. Results A total of 12 clinical trials with 1,387 patients were included. The pooled analysis showed a significant improvement of RFS, PFS and OS in CIK group (HR 0.56, 95% CI 0.47-0.67, p<0.00001 for RFS; HR 0.53, 95% CI 0.40-0.69, p<0.00001 for PFS; HR 0.59, 95% CI 0.46-0.77, p<0.0001 for OS). The proportion of CD4+ T cells increased significantly, while CD8+ T cells decreased significantly after CIKs therapy (WMD 4.07, 95% CI 2.58-5.56, p<0.00001; WMD -2.84, 95% CI -4.67 to -1.01, p=0.002, respectively). No significant differences of adverse events between CIK and non-CIK group existed. Conclusions Conventionally invasive therapies combined with CIKs therapy could improve the prognosis of HCC patients, especially for RFS and PFS, with mild side effects. Optimizing patient selection shall be the direction in future studies.