Dendritic Cell-Based Immunotherapy Targeting Synthesized Peptides for Advanced Biliary Tract Cancer
Dendritic Cell-Based Immunotherapy Targeting Synthesized Peptides for Advanced Biliary Tract Cancer
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DOI：
10.1007/s11605-013-2286-2
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发表时间：
2013-09-01
影响因子：
3.2
通讯作者：
Nagaya, Masaki
中科院分区：
文献类型：
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作者：
Kobayashi, Masanori;Sakabe, Tomoyo;Nagaya, Masaki
为探讨以合成肽Wilms tumor 1（WT 1）和细胞表面相关粘蛋白1（MUC 1）为靶点的树突状细胞（DC）免疫治疗胆道癌（BTC）的安全性和有效性，选取65例不能切除、复发或转移的BTC患者，进行DC免疫治疗。DC用WT 1和/或MUC 1脉冲。对不良事件（AE）和临床反应进行了检查，未观察到严重的治疗相关AE。自诊断和首次接种疫苗起的中位生存时间（MST）分别为18.5和7.2个月。多因素考克斯比例风险分析显示，影响免疫接种后发热的独立因素为：（1）联合化疗;（2）免疫接种前白蛋白水平<4.0 g/dL;（3）免疫接种前C反应蛋白水平< 0.5 mg/dL;从第一次接种开始，有或没有化疗的MST分别为8.2和5.3个月（P = 0.016），预后营养指数a <40和a < 40的患者MST分别为8.1和5.0个月虽然是一项小型非对照非随机研究，但基于DC的BTCs免疫治疗是安全的，并且对接受化疗并保持良好营养状态的患者产生了临床反应。
The aim of this retrospective study was to clarify the safety and efficacy of dendritic cell (DC)-based immunotherapy targeting synthesized peptides, Wilms tumor 1 (WT1) and Mucin 1, cell surface associated (MUC1) for biliary tract cancers (BTCs).Sixty-five patients who had nonresectable, recurrent, or metastatic BTCs and received the DC-based immunotherapy were selected for the study. DCs were pulsed with WT1 and/or MUC1. The adverse events (AEs) and clinical responses were examined.No serious treatment-related AEs were observed. Median survival time (MST) from diagnosis and from the first vaccination was 18.5 and 7.2 months, respectively. By multivariate Cox proportional hazard analysis, the significant independent factors were found to be (1) combined chemotherapy, (2) albumin level a parts per thousand yen4.0 g/dL before vaccination, (3) C-reactive protein level < 0.5 mg/dL before vaccination, and (4) fever after vaccination. The MST from the first vaccination with or without chemotherapy was 8.2 and 5.3 months, respectively (P = 0.016), and MST for the patients with prognostic nutritional index a parts per thousand yen40 and < 40 was 8.1 and 5.0 months, respectively (P = 0.023).Although a small uncontrolled nonrandomized study, DC-based immunotherapy for BTCs was safe and produced a clinical response for the patients who underwent chemotherapy and maintained a good nutrition status.