Feasibility study of DCs/CIKs combined with thoracic radiotherapy for patients with locally advanced or metastatic non-small-cell lung cancer.
BACKGROUND
The combination of dendritic cells (DCs) and cytokine-induced killer cells (CIKs) can induce the anti-tumor immune response and radiotherapy may promote the activity. We aimed to explore the feasibility of DCs/CIKs combined with thoracic radiotherapy (TRT) for patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC).


METHODS
In this study, patients with unresectable stage III/IV NSCLC and an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-2 and previously receiving two or more cycles of platinum-based doublet chemotherapy without disease progression received TRT plus DCs/CIKs or TRT alone until disease progression or unacceptable toxicity. The primary endpoint was median progression-free survival (mPFS). In treatment group, patients received four-cycle autologous DCs/CIKs infusion starting from the 6(th) fraction of irradiation.


RESULTS
From Jan 13, 2012 to June 30, 2014, 82 patients were enrolled, with 21 patients in treatment group and 61 in control group. The mPFS in treatment group was longer than that in control group (330 days vs 233 days, hazard ratio 0.51, 95 % CI 0.27-1.0, P < 0.05), and the objective response rate (ORR) of treatment group (47.6 %) was significantly higher that of control group (24.6 %, P < 0.05). There was no significant difference in disease control rate (DCR) and median overall survival (mOS) between two groups (P > 0.05). The side effects in treatment group were mild and there was no treatment-related deaths.


CONCLUSIONS
The combination of DCs/CIKs with TRT could be a feasible regimen in treating locally advanced or metastatic NSCLC patients. Further investigation of the regimen is warranted.
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
Luping
L
Zhang
Oncology Department, Leshan People's Hospital, Sichuan, 614000, China.
Yanmei
Y
Xu
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
Jie
J
Shen
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
Feng
F
He
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
Dan
D
Zhang
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
Zhengtang
Z
Chen
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China. cqxqyy@foxmail.com.
Yuzhong
Y
Duan
Cancer Institute of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China. sunjg09@aliyun.com.
Jianguo
J
Sun
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000379:methods; D016207:Cytokines / Q000378:metabolism; D003713:Dendritic Cells / Q000166:cytology; D018450:Disease Progression; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007107:Immune System; D053208:Kaplan-Meier Estimate; D007694:Killer Cells, Natural / Q000166:cytology; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
D016207:Cytokines
Dendritic cells; cytokine-induced killer cells; cytotherapy; non-small cell lung cancer; thoracic radiotherapy