Adoptive T-cell transfer and chemotherapy in the first-line treatment of metastatic and/or locally recurrent nasopharyngeal carcinoma.
Adoptive T-cell transfer and chemotherapy in the first-line treatment of metastatic and/or locally recurrent nasopharyngeal carcinoma.
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DOI：
10.1038/mt.2013.242
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发表时间：
2014-01
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影响因子：
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转移性或局部复发性EB病毒（EBV）阳性鼻咽癌（NPC）患者的结局仍然很差。EB病毒特异性细胞毒性T淋巴细胞（EBV-CTL）的连续免疫治疗已被证明具有临床疗效，但从未在一线治疗环境中与化疗联合使用。为了评估化疗与过继性EBV-CTL转移相结合的安全性和有效性，我们进行了一项2期临床试验，包括四个周期的吉西他滨和卡铂（GC），随后是多达六个剂量的EBV-CTL。38例患者入组，35例接受GC和EBV-CTL。GC-CTL治疗的有效率为71.4%，其中3例完全缓解，22例部分缓解。中位随访时间为29.9个月，2年和3年总生存率（OS）分别为62.9%和37.1%。5例患者自开始CTL治疗后超过34个月不需要进一步化疗。输注含有LMP 2特异性T细胞的CTL产物与OS正相关（风险比：0.35; 95%置信区间：0.14-0.84; P = 0.014）。我们的研究在晚期NPC患者中取得了最好的生存结局之一，为未来使用和不使用EBV-CTL的化疗随机研究奠定了基础。
The outcomes for patients with metastatic or locally recurrent Epstein–Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) remain poor. Adoptive immunotherapy with EBV-specific cytotoxic T lymphocytes (EBV-CTLs) has proven clinical efficacy, but it has never been evaluated in the first-line treatment setting in combination with chemotherapy. To evaluate the safety and efficacy of a chemotherapy in combination with adoptive EBV-CTL transfer, we conducted a phase 2 clinical trial consisting of four cycles of gemcitabine and carboplatin (GC) followed by up to six doses of EBV-CTL. Thirty-eight patients were enrolled, and 35 received GC and EBV-CTL. GC-CTL therapy resulted in a response rate of 71.4% with 3 complete responses and 22 partial responses. With a median follow up of 29.9 months, the 2-year and 3-year overall survival (OS) rate was 62.9 and 37.1%, respectively. Five patients did not require further chemotherapy for more than 34 months since initiation of CTL. Infusion of CTL products containing T cells specific for LMP2 positively correlated with OS (hazard ratio: 0.35; 95% confidence interval: 0.14–0.84; P = 0.014). Our study achieved one of the best survival outcomes in patients with advanced NPC, setting the stage for a future randomized study of chemotherapy with and without EBV-CTL.
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影响因子：
11.5
作者：
Chang, Kai-Ping;Hao, Sheng-Po;Yu, Jau-Song
通讯作者：
Yu, Jau-Song
DOI：
10.1002/hed.21890
发表时间：
2012-08-01
影响因子：
2.9
作者：
Hsu, Cheng-Lung;Chang, Kai-Ping;Wang, Hung-Ming
通讯作者：
Wang, Hung-Ming
影响因子：
50.5
作者：
Chia, W. K.;Wang, W. -W.;Toh, H. C.
通讯作者：
Toh, H. C.
影响因子：
6.2
作者：
Leong, Swan Swan;Wee, Joseph;Tan, Eng Huat
通讯作者：
Tan, Eng Huat
影响因子：
45.3
作者：
Siu, LL;Czaykowski, PM;Tannock, IF
通讯作者：
Tannock, IF