Clinical efficacy analysis of dendritic cell-cytokine induced killer cell immunotherapy combined with paclitaxel-cisplatin chemotherapy in patients with advanced ovarian cancer

DC-CIK- CHEMOTHERAPY

DC-CIK-CHEMOTHERAPY

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Summary

The study aims to investigate the efficacy and safety of dendritic cellcytokine induced killer cell (DC-CIK) immunotherapy combined with paclitaxel-cisplatin chemotherapy in the treatment of patients with advanced ovarian cancer. The treatment revealed its effects in improving clincal efficacy, enhance the immune function and raise the quality of life and prolong the survival rate.

Patients characteristics

136 patients diagnosed with stage IV ovarian cancer via pathological examination and the International Federation of Gynecology and Obstetrics (FIGO 2004) surgicopathological staging criteria, all patients had an expected survival time >6 months with normal hematopoietic system, liver, kidney and heart functions and with a Karnofsky performance scale score ≥60 points.

Methodology

DC-CIK cell preparation
50 mL of peripheral blood was drawn from each patient 1 week before treatment, and DC-CIKs were prepared. After centrifugation, the plasma was taken out, diluted with normal saline and Dulbecco’s Modified Eagle’s Medium (DMEM). Then the mononuclear cells in the boundary layer were collected, washed with DMEM, suspended at a certain concentration, added with recombinant human interferon-γ, and cultured in an incubator with 50 mL/L CO2 at 37°C. Two days later, the cluster of differentiation 3 (CD3) and recombinant human interleukin-2 (rhIL-2) culture medium was added and replaced every 3 days, and rhIL-2 culture medium was supplemented. After culture for about 1 week, the mixture was infused at the intermission of chemotherapy.

Treatment

In the Chemotherapy group, conventional TC chemotherapy (paclitaxel+carboplatin) was administered: Paclitaxel (175 mg/m2) and cisplatin (75 mg/m2) were intravenously injected on the 1st day of each cycle.
In the DC-CIK group, DC-CIK immunotherapy combined with TC chemotherapy was administered: On day 1 before TC chemotherapy, DC-CIKs cultured by the peripheral blood were used for treatment. The treatment lasted for 3 cycles (21 days as 1 cycle) in both groups.

Results

Short-term efficacy
The efficacy of all patients was evaluated 1 month after treatment. In the DC-CIK group, there were 12 (17.6%) cases of complete remission (CR), 31 (45.6%) cases of partial response (PR), 19 (27.9%) cases of stable disease (SD) and 6 (8.8%) cases of progressed disease (PD), and the ORR and DCR were 63.2% (43 cases) and 91.2% (62 cases), respectively.
In the Chemotherapy group, there were 6 (8.8%) cases of CR, 24 (35.3%) cases of PR, 22 (32.4%) cases of SD and 16 (23.5%) cases of PD, and the ORR and DCR were 44.1% (30 cases) and 76.5% (52 cases), respectively. It can be seen that both ORR and DCR in the DC-CIK group were significantly better than those in the Chemotherapy group.Adverse reactions
During treatment, the main adverse reactions were leukopenia, anemia, nausea and vomiting, liver and renal function damage and peripheral neurotoxicity. The incidence rate of leukopenia and liver function damage was distinctly lower in the DC-CIK group than that in the Chemotherapy group.
Comparison of QLQ-C30 score between the two groups after treatment
The quality-of-life status was recorded via follow-up within 1 month after treatment. The score of emotional functioning in function module of QLQ-C30 scale was improved in the DC-CIK group, manifested as stable emotion, and less depression and rage, which was greatly higher than in the Chemotherapy group. The score of nausea and vomiting in symptom module was greatly lower in the DC-CIK group than in the Chemotherapy group.
Survival
All of the 136 patients were followed up for 6-60 months. The median survival time was 36.9±6.5 months and 31.2±5.3 months, and the 3-year overall survival (OS) rate was 48.5% (33/68) and 35.3% (24/68), respectively, in the DC-CIK group and the Chemotherapy group. The results of log- rank test showed that the OS rate in the DC- CIK group was remarkably superior to that in the Chemotherapy group.

Conclusion

DC-CIK immunotherapy combined with paclitaxel-cisplatin chemotherapy can greatly improve the clinical efficacy, enhance the immune function of patients, reduce the levels of serum tumor markers, raise the quality of life and prolong the survival of patients in the treatment of advanced ovarian cancer.

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Scientific article publishing date 11/14/2020

Immucura identifier BSC21_254EN

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