Prospective study of cyclophosphamide, thiotepa, carboplatin combined with adoptive DC-CIK followed by metronomic cyclophosphamide therapy as salvage treatment for triple negative metastatic breast cancers patients (aged <45).
BACKGROUND
The recent immunotherapy treatment on triple-negative breast cancer (TNBC) leads to the breakthrough assignation. In this study, we have tried the new combinations of specific chemo with DC-CIKs immunotherapy to treat those patients.


METHODS
Twenty-three metastatic anthracyclines and taxanes pretreated TNBC younger (mean 41.5 years) patients were initially mobilized with cyclophosphamide (3 g/m(2)) for the preparation of CD34(+) peripheral blood mononuclear cells as the resources for generating DC/CIKs and marrow function supports. All cases were subsequently experienced 2 cycles of chemotherapy with cyclophosphamide 3 g/m(2), thiotepa 150 mg/m(2), and carboplatin AUC = 6, Q4w. The patients then received 3 infusions of DC-CIKs at the chemo intervals and followed by maintenance therapy with oral cyclophosphamide 50 mg daily. The endpoints were progression-free survival and overall survival.


RESULTS
The partial response rate was 13.0 %, stable and progressive disease rates were 56.5 and 30.4 %, respectively. The median PFS was 13.5 months (95 % confidence interval (CI) 10.1-16.9 months) and OS was 15.2 months (95 % CI 12.5-18.1 months). The most common serious adverse events were neutropenia (100.0 %) and anemia (69.7 %) but without treatment-related mortality.


CONCLUSIONS
These data suggested that such combination therapy model be effective and safe for younger metastatic TNBC exposure to previous anthracyclines and taxanes based adjuvant chemotherapy.
Beijing Key Laboratory of Therapeutic Cancer Vaccines, Beijing Shijitan Hospital, Capital Medical University Cancer Center, 10 Tieyi Road, Beijing, 100038, China.|Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
X
X
Wang
Beijing Key Laboratory of Therapeutic Cancer Vaccines, Beijing Shijitan Hospital, Capital Medical University Cancer Center, 10 Tieyi Road, Beijing, 100038, China. renjun9688@yahoo.com.|Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China. renjun9688@yahoo.com.|Department of Surgery, Duke University Medical Center, 571 Research Drive, Suite 433, Box 2606, Durham, NC, 27710, USA. renjun9688@yahoo.com.
J
J
Ren
Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
J
J
Zhang
Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
Y
Y
Yan
Beijing Key Laboratory of Therapeutic Cancer Vaccines, Beijing Shijitan Hospital, Capital Medical University Cancer Center, 10 Tieyi Road, Beijing, 100038, China.
N
N
Jiang
Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
J
J
Yu
Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
L
L
Di
Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
G
G
Song
Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
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L
Che
Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
J
J
Jia
Beijing Key Laboratory of Therapeutic Cancer Vaccines, Beijing Shijitan Hospital, Capital Medical University Cancer Center, 10 Tieyi Road, Beijing, 100038, China.|Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
X
X
Zhou
Beijing Key Laboratory of Therapeutic Cancer Vaccines, Beijing Shijitan Hospital, Capital Medical University Cancer Center, 10 Tieyi Road, Beijing, 100038, China.|Department of Medical Oncology, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, 100142, China.
H
H
Yang
Department of Surgery, Duke University Medical Center, 571 Research Drive, Suite 433, Box 2606, Durham, NC, 27710, USA. kim.lyerly@dm.duke.edu.
H K
HK
Lyerly
D059250:Administration, Metronomic; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D003713:Dendritic Cells / Q000637:transplantation*; D005260:Female; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D016879:Salvage Therapy / Q000009:adverse effects / Q000379:methods*; D013852:Thiotepa / Q000008:administration & dosage / Q000009:adverse effects; D064726:Triple Negative Breast Neoplasms / Q000401:mortality / Q000628:therapy*
D003520:Cyclophosphamide; D013852:Thiotepa; D016190:Carboplatin
Immunotherapy; Thiotepa; Triple negative breast cancer; Younger