Phase Ⅰ clinical study of combination therapy with microwave ablation and cellular immunotherapy in hepatocellular carcinoma.
OBJECTIVE
To observe safety and influence on viral load and peripheral T lymphocyte subsets of combination therapy with percutaneous microwave ablation (PMWA) and adoptive immunotherapy in hepatocellular carcinoma (HCC) with hepatitis B.


RESULTS
No adverse effects of grade Ⅲ/Ⅳ were observed. Viral load was decreased in 57.14% (four of seven) of patients and was undetectable in two (28.6%) patients without antiviral therapy. The percentage of CD4(+)CD25(high) regulatory T lymphocytes decreased significantly, and the percentage of CD8(+)CD28(-) effector cells increased significantly 1 month after therapy. However, 6 months after therapy, there was no significant difference.


METHODS
Ten HCC (D≤5 cm, fewer than 3 tumors) patients were treated with radical PMWA and three courses of immunotherapy, which were started with PMWA, 2 weeks post-PMWA, and 3 months after PMWA. Peripheral blood mononuclear cells were differentiated into phenotypically confirmed DCs and effector cells. Immature DCs, cytokine-induced killer cells (CIK) and cytotoxic T lymphocytes (CTL) were injected into the marginal area of ablated tumors under contrast-enhanced sonographic guidance. Under sonographic guidance, tumor lysate-pulsed DC was injected into groin lymph nodes, while DC-CIK and CTL were injected into the abdominal cavity. CIK was infused intravenously.


CONCLUSIONS
Adoptive immunotherapy prescribed soon after PMWA for HCC patients was safe and ameliorated the percentage of peripheral lymphocytes.
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
Pei
P
Zhou
Ping
P
Liang
Baowei
B
Dong
Xiaoling
X
Yu
Zhiyu
Z
Han
Yingxin
Y
Xu
D055011:Ablation Techniques; D000328:Adult; D000368:Aged; D018106:CD28 Antigens / Q000032:analysis / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D003131:Combined Modality Therapy; D055612:Cytokine-Induced Killer Cells / Q000276:immunology; D003713:Dendritic Cells / Q000276:immunology; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D016219:Immunotherapy, Adoptive; D053645:Interleukin-2 Receptor alpha Subunit / Q000032:analysis / Q000276:immunology; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000528:radiation effects; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D019562:Viral Load / Q000528:radiation effects
D018106:CD28 Antigens; D053645:Interleukin-2 Receptor alpha Subunit