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由树突细胞 - 细胞因子诱导、杀伤细胞介导的胰腺癌免疫治疗的临床应用: 最新的荟萃分析

 

Authors Zhang YC, Zhang X, Zhang AQ, Li K, Qu K

Received 7 June 2017

Accepted for publication 4 August 2017

Published 23 August 2017 Volume 2017:10 Pages 4173—4192

DOI https://doi.org/10.2147/OTT.S143382

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Carlos Vigil Gonzales

Purpose: This study aimed to systematically evaluate the efficacy and safety of dendritic cells–cytokine-induced killer (DC–CIK) cells immunotherapy in treating pancreatic cancer (PC) patients.
Methods: Data were collected from published articles of clinical trials. Databases including Web of Science, EMBASE, PubMed, Cochrane Library, Wanfang, and CNKI were searched. The main outcome measures in this research included the overall response rate (ORR), disease control rate (DCR), overall survival (OS), patients’ quality of life (QoL), immune function, and adverse events. Comparative analysis was conducted between DC–CIK immunotherapy and chemotherapy (combined therapy) and chemotherapy alone.
Results: This analysis covered 14 trials with 1,088 PC patients involved. The combined therapy showed advantages over chemotherapy alone in ORR (odds ratio [OR] =1.69, 95% confidence interval [CI] =1.20–2.38, =0.003), DCR (OR =2.33, 95% CI =1.63–3.33, <0.00001), OS (1-year OS, OR =3.61, 95% CI =2.41–5.40, <0.00001; 3-year OS, OR =2.65, 95% CI =1.56–4.50, =0.0003) and patients’ QoL (<0.01) with statistical significance. After immunotherapy, lymphocyte subsets’ percentages of CD3
+ (<0.00001), CD4+ (=0.01), CD3+CD56+ (<0.00001), and cytokine levels of IFN-γ (<0.00001) were significantly increased, and the percentages of CD4+CD25+CD127low (<0.00001) and levels of IL-4 (<0.0001) were significantly decreased, whereas analysis on CD8(=0.59) and CD4+/CD8+ ratio (=0.64) did not show a significant difference.
Conclusion: The combination of DC–CIK immunotherapy and chemotherapy is effective for PC treatment, indicated by prolonging the PC patients’ survival time, which benefit from reconstructed immune function of patients.
Keywords: cytokine-induced killer cells, dendritic cells, pancreatic cancer, immunotherapy, meta-analysis