title: Prolonged overall survival in gastric cancer patients after adoptive immunotherapy.
abstract: OBJECTIVE
  To assess the efficacy of immunotherapy with expanded activated autologous lymphocytes (EAALs) in gastric cancer.
  
  
  METHODS
  An observational study was designed to retrospectively analyze the clinical data of 84 gastric cancer patients, of whom 42 were treated by EAAL immunotherapy plus conventional treatment and another 42 only received conventional treatment (control group). EAALs were obtained by proliferation of peripheral blood mononuclear cells from patients followed by phenotype determination. Clinical data including age, gender, clinical stage, chemotherapeutic regimens, hospitalization, surgical, radiotherapy, and survival data were collected along with EAAL therapy details and side effects. Patients were followed and the relationship between treatment and overall survival (OS) data obtained for the immunotherapy and control groups were compared retrospectively. The safety of EAAL immunotherapy was also evaluated.
  
  
  RESULTS
  After in vitro culture and proliferation, the percentages of CD3+, CD3+CD8+, CD8+CD27+, CD8+CD28+, and CD3+CD16+/CD56+ cells increased remarkably (P < 0.05), while the percentages of CD3+CD4+, CD4+CD25+, and CD3-CD16+/CD56+ (natural killer cells) were overtly decreased (P < 0.05); no significant change was observed in CD4+CD25+CD127- cells (P = 0.448). Interestingly, OS in the immunotherapy group was significantly higher than that in the control group, with 27.0 and 13.9 mo obtained for the two groups, respectively (P = 0.028, HR = 0.573, 95%CI: 0.347-0.945). These findings indicated a 42.7% decrease in the risk of death. In addition, we found that clinical stage and application of EAAL immunotherapy were independent prognostic factors for gastric cancer patients. Indeed, the OS in stage IIIc and IV patients that had received surgery was prolonged after EAAL immunotherapy (P < 0.05). Importantly, in vitro induction and proliferation of EAAL were easy and biologically safe.
  
  
  CONCLUSIONS
  Overall, EAAL adoptive immunotherapy might prolong the OS in gastric cancer patients.
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Zhang
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jian-Yu
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jin-Yu
authors.initials: JY
authors.lastname: Li
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Yan
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Liang-Liang
authors.initials: LL
authors.lastname: Wu
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Xiao-Gang
authors.initials: XG
authors.lastname: Zhang
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Guo-Qing Zhang, Hong Zhao, Jian-Yu Wu, Jin-Yu Li, Xiang Yan, Shun-Chang Jiao, Department of Clinical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Shun-Chang
authors.initials: SC
authors.lastname: Jiao
mesh_terms: D001804:Blood Transfusion, Autologous; D049109:Cell Proliferation; D002478:Cells, Cultured; D006801:Humans; D016130:Immunophenotyping; D016219:Immunotherapy, Adoptive / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D053208:Kaplan-Meier Estimate; D017710:Lymphocyte Transfusion / Q000009:adverse effects / Q000401:mortality; D008214:Lymphocytes / Q000276:immunology*; D009367:Neoplasm Staging; D010641:Phenotype; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D019139:Tumor Escape
keywords: Adoptive immunotherapy; Expanded activated autologous lymphocytes; Gastric cancer; Lymphocytes; Observational study