Maintenance Therapy With Autologous Cytokine-induced Killer Cells in Patients With Advanced Epithelial Ovarian Cancer After First-line Treatment
Maintenance Therapy With Autologous Cytokine-induced Killer Cells in Patients With Advanced Epithelial Ovarian Cancer After First-line Treatment
复制标题
一线治疗后晚期上皮性卵巢癌患者自体细胞因子诱导杀伤细胞的维持治疗
DOI：
10.1097/cji.0000000000000021
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发表时间：
2014-02-01
影响因子：
3.9
通讯作者：
Hao, Xishan
中科院分区：
文献类型：
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作者：
Liu, Jun;Li, Hui;Hao, Xishan
细胞因子诱导的杀伤（CIK）细胞在体外和体内都显示出对卵巢癌细胞的细胞溶解能力。本研究旨在评价CIK细胞维持治疗一线治疗后的晚期上皮性卵巢癌患者的临床疗效。在细胞减灭术后接受6-8个疗程卡铂/紫杉醇化疗的IIB-IV期上皮性卵巢癌患者中进行了配对研究。共92例一线治疗后达到完全缓解的患者入组本研究。治疗组46例，每月输注CIK细胞;对照组46例，观察并随访。评价无进展生存期（PFS）、总生存期（OS）和毒性。我们的结果显示，治疗组的中位PFS为37.7个月，对照组为22.2个月（P=0.004）。然而，尽管治疗组的中位OS（61.5个月）长于对照组（55.9个月），但无显著差异（P=0.289）。亚组分析显示，免疫治疗的PFS生存优势与减瘤手术的范围和病理分期无关。CIK细胞输注2个疗程后，外周血中CD 4 + CD 25 + CD 127 −正规T细胞比例显著下降（P=0.006）。CIK细胞输注过程中未发现III、IV级不良反应。CIK细胞维持治疗可改善一线治疗后晚期卵巢癌患者的PFS，且副作用轻微。然而，OS方面的好处仍有待确定。
Cytokine-induced killer (CIK) cells have shown cytolytic ability against ovarian cancer cells in vitro and in vivo. This study was aimed to evaluate the clinical efficacy of maintenance therapy of CIK cells in patients with advanced epithelial ovarian cancer after first-line treatment. A paired study was performed in patients with stages IIB–IV epithelial ovarian cancer after cytoreductive surgery followed by 6–8 courses of carboplatin/paclitaxel chemotherapy. A total of 92 patients who achieved complete remission after first-line treatment were enrolled in this study. Forty-six patients in the treatment group received CIK cells transfusion monthly, whereas the other 46 patients in the control group received observation with follow-up. Progression-free survival (PFS), overall survival (OS), and toxicity were evaluated. Our results showed that median PFS was 37.7 months in the treatment group and 22.2 months in the control group (P=0.004). However, although median OS in the treatment group (61.5 mo) was longer than that in the control group (55.9 mo), there was no significant difference (P=0.289). The subgroup analysis revealed that the survival advantage of PFS from immunotherapy was independent of the extent of debulking surgery and pathologic stage. After 2 courses of CIK cells transfusion, the proportion of CD4+CD25+CD127− regular T cells in the peripheral blood significantly decreased (P=0.006). No grades III and IV adverse reaction were found during CIK cells infusion. Maintenance therapy with CIK cells improved the PFS in patients with advanced ovarian cancer after first-line treatment with slight side effects. However, the benefits with respect to OS are still pending.