Clinical outcome of immunotherapy with dendritic cell vaccine and cytokine-induced killer cell therapy in hepatobiliary and pancreatic cancer

Abstract

Abstract. The aim of this study was to determine the therapeutic effects of adoptive immunotherapy following dendritic cell (DC) vaccine and cytokine-induced killer (CIK) cell therapy and evaluate its cytotoxicity, survival benefits and quality of life (QOL) changes in patients with hepatobiliary and pancreatic cancer (HPC). We performed a retrospective analysis of 407 clinical cases, including 77 patients with HPC who received immunotherapy with DC vaccine and CIK cells (I group) and 330 patients with similar characteristics who underwent baseline treatment but did not receive immunotherapy [non-immunotherapy (NI) group)] as the control group. After a follow-up period of 294±207.5 days, the median survival time (MST) of the two groups was compared using the Kaplan-Meier method. In the I group, 61% of the patients developed a positive, delayed-type hypersensitivity response and 65% of the patients exhibited an improvement in QOL. The most notable adverse events included fever (28%), insomnia (25%), anorexia (17%), skin rash (12%) and arthralgia (31%). No severe toxicities were observed in patients in the I group; in addition, the MST was significantly longer in the I group compared with that in the NI group (P=0.014). Thus, the DC vaccine and CIK cell therapy was associated with mild adverse effects, but was able to induce an immune response and effectively eliminate tumor cells, thereby improving the QOL and prolonging the MST of the patients. IntroductionHepatobiliary and pancreatic cancer (HPC) is a major threat to human health, with an increasing incidence over the last few years. Surgery, chemotherapy and radiotherapy are currently the mainstay of treatment for HPC. Although surgery is the first treatment of choice, early-stage cancer is diagnosed in a limited number of patients (1,2). Furthermore, the hepatobiliary and pancreatic systems exhibit a complex anatomical structure and serve important physiological functions. Consequently, HPC symptoms lack specificity and have typically reached an advanced stage at diagnosis. Radical resection of HPC is not typically performed, and the majority of HPCs are associated with a poor prognosis (3,4). Chemotherapy and radiotherapy are the primary treatments for advanced-stage disease; however, these treatments may result in major health issues and are associated with severe treatment-related toxicity. Furthermore, the overall health status of HPC patients is generally poor, which may prevent them from being eligible for these standard therapies (2,5).In addition to the common factors affecting the prognosis of cancer patients (disease stage, tumor size, lymph node metastasis and radical surgery), individual differences in the immune factors among patients also affect prognosis. As all cancer patients exhibit varying degrees of low immunity and a significant proportion are in an immunosuppressed state, recovering anticancer immunity is a possible approach to cancer treatment. Autologous immune cell therapy has been the fourth most commonly used treatment method for ca...

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