Dendritic cell vaccine and cytokine-induced killer cell therapy for the treatment of advanced non-small cell lung cancer

Abstract

Abstract. The present study aimed to evaluate the survival time, immune response and safety of a dendritic cell (DC) vaccine and cytokine-induced killer (CIK) cell therapy (DC-CIK) in advanced non-small cell lung cancer (NSCLC). The present retrospective study enrolled 507 patients with advanced NSCLC; 99 patients received DC-CIK [immunotherapy group (group I)] and 408 matched patients did not receive DC-CIK, and acted as the control [non-immunotherapy group (group NI)]. Delayed-type hypersensitivity (DTH), quality of life (QOL) and safety were analyzed in group I. The follow-up period for the two groups was 489.2±160.4 days. The overall survival (OS) time was calculated using the Kaplan-Meier method. DTH was observed in 59 out of 97 evaluated patients (60.8%) and 67 out of 98 evaluated patients (68.4%) possessed an improved QOL. Fever and a skin rash occurred in 36 out of 98 patients (36.7%) and 7 out of 98 patients (7.1%) in group I. DTH occurred more frequently in patients with squamous cell carcinoma compared with patients with adenocarcinoma (77.1 vs. 40.4%; P=0.0013). Radiotherapy was not associated with DC-CIK-induced DTH (72.7 vs. 79.6%; P=0.18), but chemotherapy significantly reduced the rate of DTH (18.2 vs. 79.6%; P=0.00). The OS time was significantly increased in group I compared with group NI (P=0.03).In conclusion, DC-CIK may induce an immune response against NSCLC, improve the QOL, and prolong the OS time of patients, without adverse effects. Therefore, the present study recommends DC-CIK for the treatment of patients with advanced NSCLC. IntroductionLung cancer is the leading cause of cancer-associated mortality and the most common cancer type worldwide (1). In total, ~80% of all lung cancer cases are non-small cell lung cancer (NSCLC) (2), for which surgery, chemotherapy and radiotherapy remain the standard treatments (3). The majority of patients with NSCLC are not recommended for surgery, since patients are often diagnosed at an advanced stage of disease (stage IIIb or IV). Patients that do undergo radical surgery may eventually develop locoregional recurrence or distant metastasis (4). Characterized by inexorable disease progression, advanced NSCLC usually has a high malignant potential. Its prognosis is poor and the clinical onset is extensive, despite treatment with chemotherapy and radiation (5). Systemic chemotherapy is the recommended first-line treatment for patients with advanced stage and metastatic NSCLC, but it is often considered ineffective or excessively toxic (6).Multidisciplinary approaches are required to develop novel treatments for advanced NSCLC (7). One of these multidisciplinary approaches is immunotherapy (7,8), an important and effective method in cancer treatment, particularly for advanced-stage disease (9). Immune cells, including cytokine-induced killer (CIK) cells and dendritic cells (DCs), aid in mounting an effective immune response against cancer cells and kill cancer cells, including residual cells (10-13). A combination of conventional methods, such as surgery...

Re-Emergence of Dendritic Cell Vaccines for Cancer Treatment

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