Adoptive cellular immunotherapy for non-small cell lung cancer: a pilot study.
BACKGROUND
Priming with autologous tumor vaccine followed by ex vivo expansion of activated T cells is a feasible experimental strategy. This paper describes the application of this cellular therapy to treat patients with late-stage non-small-cell lung cancer (NSCLC).


METHODS
Twenty-one patients with Stages III and IV NSCLC were treated. Tumor samples were obtained surgically (five patients) or by using aco-axial biopsy needle (16 patients). Each course of vaccination consisted of irradiated tumor cells, mixed with GM-CSF and injected intradermally on Day 1, followed by GM-CSF only on Days 2- 5. The course was repeated 10-14 days later. Lymphocytes were collected 10-14 day after the second course and ex vivo expanded using IL-2 and anti-CD3 Ab. The expansion products were then re-infused into the patients.


RESULTS
Twelve out of 16 biopsies resulted in optimal cell numbers for vaccine preparation. Nineteen out of 21 patients achieved a delayed type hypersensitivity (DTH response after two courses of vaccination. In 18/21 patients, the ex vivo expansion products contained > 1.6 x 10(10) cells. Subset analysis showed 77.0-97.2% T cells with a CD4:CD8 ratio of 0.65-4.0; natural killer cells were 2.0-18.6%. There were no significant toxicities. The median survival of all 21 patients was 18.6 months, with a 1-year survival of 51.6%.


CONCLUSIONS
Autologous tumor cell-vaccination may be combined with ex vivo expansion of lymphocytes as adoptive cellular immunotherapy for advanced NSCLC. Overall survival in this cohort of poor prognosis patients compared favorably with results reported in the literature.
Chan
B
B
Biological Therapy Unit, Hong Kong Sanatorium & Hospital, Hong Kong, PRC.
Lee
W
W
Hu
C X L
CX
Ng
P
P
Li
K W
KW
Lo
G
G
Ho
G
G
Yeung
D W
DW
Woo
D
D
D002289:Carcinoma, Non-Small-Cell Lung / Q000628:therapy*; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology; D006133:Growth Substances / Q000494:pharmacology; D006801:Humans; D016219:Immunotherapy, Adoptive; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013601:T-Lymphocytes / Q000276:immunology / Q000637:transplantation*; D014182:Transplantation, Autologous; D014407:Tumor Cells, Cultured / Q000187:drug effects / Q000637:transplantation
D006133:Growth Substances; D016178:Granulocyte-Macrophage Colony-Stimulating Factor