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细胞免疫治疗联合铂类化疗延长非小细胞肺癌患者的生存期

英文原题:Cellular immunotherapy combined with platinum-based chemotherapy prolongs survival for non-small cell lung cancer patients.

查看英文原题

Cellular immunotherapy combined with platinum-based chemotherapy prolongs survival for non-small cell lung cancer patients.

PubMed 2023/03/30(内容时间) Neoplasma Q3 · IF 2.5(JCR 2025)

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中文摘要

以铂类为基础的化疗是无驱动基因突变的晚期非小细胞肺癌(NSCLC)患者的主要治疗选择,但其疗效仍然有限。通过潜在的协同效应,由细胞因子诱导的杀伤(CIK)细胞、自然杀伤(NK)细胞和T细胞组成的自体细胞免疫治疗(CIT)可能增强其疗效。NK细胞在铂类治疗后对肺癌细胞(A549细胞)表现出体外细胞毒性。使用流式细胞术评估了肺癌细胞表面MICA、MICB、DR4、DR5、CD112和CD155的表达。在这项回顾性队列研究中,纳入了102例既往未治疗、不适合酪氨酸激酶抑制剂(TKI)靶向治疗的IIIB/IV期NSCLC患者,他们接受了单纯化疗(n=75)或联合治疗(n=27)。NK细胞对A549细胞的细胞毒性明显增加,并且观察到这种效应呈时间依赖性增强。铂类治疗后,A549细胞表面的MICA、MICB、DR4、DR5、CD112和CD155水平升高。在联合组中,中位PFS为8.3个月,而对照组为5.5个月(p=0.042);中位总生存期为18.00个月,而联合组为13.67个月(p=0.003)。联合组没有明显的免疫相关不良反应。NK细胞与铂类联合显示出协同抗癌作用。联合这两种策略提高了生存率,且不良反应轻微。将CIT纳入常规化疗方案可能会改善NSCLC的治疗。然而,还需要多中心随机对照试验提供更多证据。

展开英文摘要原文

Platinum-based chemotherapy is the primary treatment option for advanced non-small cell lung cancer (NSCLC) patients without a driver gene mutation, but its efficacy is still modest. Through a potential synergistic effect, autologous cellular immunotherapy (CIT) composed of cytokine-induced killer (CIK), natural killer (NK), and T cells might enhance it. NK cells exhibited in vitro cytotoxicity toward lung cancer cells (A549 cells) following platinum therapy. Using flow cytometry, the expression of MICA, MICB, DR4, DR5, CD112, and CD155 on lung cancer cells was assessed. In this retrospective cohort study, there were included 102 previously untreated stage IIIB/IV NSCLC patients ineligible for tyrosine kinase inhibitor (TKI) target therapy who received either chemotherapy alone (n=75) or combination therapy (n=27).

The cytotoxicity of NK cells for A549 cells was increased obviously and a time-dependent enhancement of this effect was also observed. After platinum therapy, the levels of MICA, MICB, DR4, DR5, CD112, and CD155 on the surface of A549 cells were increased. In the combination group, the median PFS was 8. 3 months, compared to 5. 5 months in the control group (p=0. 042); the median overall survival was 18.

00 months, compared to 13. 67 months in the combined group (p=0. 003). The combination group had no obvious immune-related adverse effects. The combination of NK cells with platinum showed synergistic anticancer effects. Combining the two strategies increased survival with minor adverse effects. Incorporating CIT into conventional chemotherapy regimens may improve NSCLC treatment.

However, additional evidence will require multicenter randomized controlled trials.

论文信息

作者
Qian L、Ding X、Li FQ、Tian HM、Chen X、Han FJ、Wang HY、Li WQ
单位
Cancer Center, The First Hospital of Jilin University, Changchun, China.China
文献类型
多中心研究
期刊
Neoplasma2023 Apr
原文标识
PubMed 37005956 · DOI 10.4149/neo_2023_230127N44