一种用于克服非小细胞肺癌治疗中抗原异质性的多靶向 CAR-T 细胞平台
A Multi-Targeting Chimeric Antigen Receptor-T Cell Platform to Overcome Antigen Heterogeneity in the Treatment of Non-Small Cell Lung Cancer.
这些发现支持采用多靶点CAR-T 策略来应对NSCLC及可能其他实体瘤中的抗原异质性。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Evaluation of the Efficacy and Safety of DC-CIK Bioimmunotherapy in the Treatment of Advanced Non-Small Cell Lung Cancer.
Evaluation of the Efficacy and Safety of DC-CIK Bioimmunotherapy in the Treatment of Advanced Non-Small Cell Lung Cancer.
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非小细胞肺癌(NSCLC)是一种发病率及死亡率均较高的恶性肿瘤。本研究旨在探讨树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)生物免疫治疗在晚期NSCLC中的疗效与安全性。选取2019年6月至2021年2月于我院接受治疗的64例NSCLC患者作为DC-CIK组,均在同步放化疗基础上接受DC-CIK生物免疫治疗。按照1:1匹配原则,另选取同期收治的64例接受同步化疗的NSCLC患者作为对照组。比较两组治疗前后的临床疗效、不良反应、生存期、免疫相关指标(NK、CD3+、CD4+、CD4+/CD8+)含量及外周血肿瘤标志物[癌胚抗原(CEA)、癌抗原(CA)125、细胞角蛋白19血清片段211(CYFRA211)、鳞状细胞癌相关抗原(SCCAg)]。治疗后,DC-CIK组总缓解率为85.94%,明显高于对照组的65.63%(p < 0.05)。
治疗明显降低了两组CD3+和CD4+含量,并大幅升高了CD4+/CD8+。DC-CIK组NK水平显著升高,而对照组NK水平大幅降低(p < 0.05)。DC-CIK组NK、CD3+、CD4+及CD4+/CD8+含量均明显高于对照组(p < 0.01)。治疗后,两组CEA、CA125、CYFRA211及SCC-Ag含量均较治疗前显著降低(p < 0.05),且DC-CIK组低于对照组(p < 0.05)。DC-CIK组发热、粒细胞减少及胃肠道反应的发生率均明显低于对照组(p < 0.01)。DC-CIK组和对照组的中位生存期分别为17个月和13个月。Kaplan-Meier生存曲线和log-rank检验进一步证明,DC-CIK生物免疫治疗延长了患者的生存期(p < 0.05)。
总之,DC-CIK生物免疫治疗在晚期NSCLC的临床治疗中有效,改善了患者的免疫功能,提高了患者2年内的生存时间,具有一定的安全性。
Non-small cell lung cancer (NSCLC) is a malignant tumor with a high incidence rate and mortality rate.
This study aims to explore the efficacy and safety of dendritic cell cytokine-induced killer cell (DC-CIK) bioimmunotherapy in advanced NSCLC. Sixty-four NSCLC patients treated in our hospital from June 2019 to February 2021 were chosen as the DC-CIK group, all of whom received DC-CIK bioimmunotherapy based on synchronous radiotherapy and chemotherapy. Following the 1:1 matching principle, another 64 NSCLC patients treated with synchronous chemotherapy admitted at the same time were picked as the control group. The clinical efficacy, adverse effects, survival period, the content of immune-related indexes (NK, CD3 + , CD4 + , CD4 + /CD8 + ), and peripheral blood tumor markers [embryonic antigen (CEA), cancer antigen (CA) 125, cytokeratin 19 serum fragment 211 (CYFRA211), squamous cell carcinoma-associated antigen (SCCAg)] were compared before and after treatment. The overall remission rate was 85. 94% in the DC-CIK group, which was much higher than 65.
63% of the control group after treatment (p < 0. 05). The treatment obviously decreased the content of CD3 + and CD4 + and largely elevated CD4 + /CD8 + in two groups. The DC-CIK group had a significantly elevated level of NK, which was largely decreased in the control group (p < 0. 05). The DC-CIK group had a markedly higher content of NK, CD3 + , CD4 + , and CD4 + /CD8 + than the control (p < 0. 01). After treatment, the content of CEA, CA125, CYFRA211, and SCC-Ag was significantly decreased in two groups than before (p < 0.
05), which was lower in the DC-CIK group than the control (p < 0. 05). The DC-CIK group had a much lower incidence of fever, granulocytopenia, and gastrointestinal reactions than the control (p < 0. 01). The DC-CIK group and the control group had a median survival of 17 months and 13 months respectively. Kaplan-Meier survival curve and log-rank test further proved that DC-CIK bioimmunotherapy prolonged the survival period of patients (p < 0. 05).
In conclusion, DC-CIK bioimmunotherapy was clinically effective in the treatment of advanced NSCLC, which improved patients' immune function, elevated the survival time of patients within 2 years with a certain degree of safety.
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