Selections of appropriate regimen of high-dose chemotherapy combined with adoptive cellular therapy with dendritic and cytokine-induced killer cells improved progression-free and overall survival in patients with metastatic breast cancer: reargument of such contentious therapeutic preferences.
BACKGROUND
We hypothesized that combination of dendritic cell (DC) with autologous cytokine-induced killer (CIK) immunotherapy in setting of high-dose chemotherapy (HDC) would be effective for selected metastatic breast cancer (MBC) patients.


METHODS
Our previous work showed thiotepa could eradicate breast cancer stem cells. From 2004 to 2009, 79 patients received standard dose chemotherapy (SDC) of 75 mg/m(2) docetaxel and 75 mg/m(2) thiotepa versus 87 patients of HDC + DC/CIK: 120 mg/m(2) docetaxel to mobilize peripheral CD34(+) progenitor cells, a sequence of HDC (120 mg/m(2) docetaxel, plus 175 mg/m(2) thiotepa) + DC/CIK, with or without 400 mg/m(2) carboplatin depending upon bone marrow function. The endpoints were response rates (RR), progression-free survival (PFS), and overall survival (OS).


RESULTS
Compared with SDC, PFS and OS were improved in HDC + DC/CIK (median PFS 10.2 vs. 3.7 months, P < 0.001; median OS 33.1 vs. 15.2 months, P < 0.001). Patients of pre-menopausal, HDC as first-line treatment after metastasis, or with visceral metastasis showed prolonged PFS and OS. SDC group also achieved the similar response as previous reports.


CONCLUSIONS
Our study demonstrated the novel combination of HDC with DC/CIK to be an effective choice for the selected MBC population, in which choosing appropriate chemo regimens played important roles, and also specific HDC regimen plus DC/CIK immunotherapy showed the clinical benefits compared with chemotherapy alone.
Department of Medical Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China, renjun9688@yahoo.com.
Jun
J
Ren
Lijun
L
Di
Guohong
G
Song
Jing
J
Yu
Jun
J
Jia
Yuling
Y
Zhu
Ying
Y
Yan
Hanfang
H
Jiang
Xu
X
Liang
Li
L
Che
Jie
J
Zhang
Fengling
F
Wan
Xiaoli
X
Wang
Xinna
X
Zhou
Herbert Kim
HK
Lyerly
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016190:Carboplatin / Q000008:administration & dosage; D018270:Carcinoma, Ductal, Breast / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D018275:Carcinoma, Lobular / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D055612:Cytokine-Induced Killer Cells / Q000276:immunology / Q000637:transplantation*; D003713:Dendritic Cells / Q000276:immunology / Q000637:transplantation*; D000077143:Docetaxel; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016219:Immunotherapy, Adoptive; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D013852:Thiotepa / Q000008:administration & dosage
D043823:Taxoids; D000077143:Docetaxel; D013852:Thiotepa; D016190:Carboplatin