Immunotherapy of DC-CIK cells enhances the efficacy of chemotherapy for solid cancer: a meta-analysis of randomized controlled trials in Chinese patients

细胞免疫治疗联合化疗对实体肿瘤疗效的荟萃分析（英文）

Objective： Professional antigen-presenting dendritic cells （DCs） and cytokine-induced killer （CIK） cells, components of anti-cancer therapy, have shown clinical benefits and potential to overcome chemotherapeutic re- sistance. To evaluate whether DC-CIK cell-based therapy improves the clinical efficacy of chemotherapy, we reviewed the literature on DC-CIK cells and meta-analyzed randomized controlled trials （RCTs）. Methods： We searched several databases and selected studies using predeflned criteria. RCTs that applied chemotherapy with and without DC-CIK cells separately in two groups were included. Odds ratio （OR） and mean difference （MD） were reported to measure the pooled effect. Results： Twelve reported RCTs （826 patients）, which were all performed on Chinese patients, were included. Combination therapy exhibited better data than chemotherapy： 1-year overall survival （OS） （OR=0.22, P〈0.01）, 2-year OS （OR=0.28, P〈0.01）, 3-year OS （OR=0.41, P〈0.01）, 1-year disease-free survival （DFS） （OR=0.16, P〈0.05）, 3-year DFS （OR=0.32, P〈0.01）, objective response rate （ORR） （OR=0.54, P〈0.01）, and disease control rate （DCR） （OR=0.46, P〈0.01）. Moreover, the levels of CD3＋ T-lymphocytes （MD=-11.65, P〈0.05） and CD4＋ T-lymphocytes （MD=-8.18, P〈0.01） of the combination group were higher. Conclusions： Immunotherapy of DC-CIK cells may enhance the efficacy of chemotherapy on solid cancer and induces no specific side effect. Further RCTs with no publishing bias should be designed to confirm the immunotherapeutic effects of DC-CIK cells.

目的:分析和研究DC-CIK细胞免疫治疗是否能够增强化疗在实体肿瘤中的疗效。创新点:首次荟萃分析了关于DC-CIK细胞免疫治疗联合化疗治疗肿瘤疗效的随机对照试验,并从多个角度对疗效进行综合评价。方法:通过文献检索及筛选,收集关于化疗联合DC-CIK细胞免疫治疗的随机对照试验(图1),并从中提取相关数据进行荟萃分析。总生存率(OS)、无病生存率(DFS)、客观缓解率(ORR)、疾病控制率(DFS)和治疗后T淋巴细胞亚型水平是本研究中的主要疗效指标,比值比(OR)(图3、4和5)以及平均差(MD)(图6)用来评价各个指标的综合效应。结论:共有12个随机对照试验被纳入我们的研究中(表1和2)。相对于单独应用化疗,DC-CIK细胞治疗联合化疗的综合疗法能在1年生存率、2年生存率、3年生存率、1年无病生存率、3年无病生存率、客观缓解率以及疾病控制率等指标上有明显优势,且接受综合疗法患者的CD3+T淋巴细胞和CD4+T淋巴细胞水平明显更高。综上所述,DC-CIK细胞免疫治疗能够增强化疗对实体肿瘤的疗效。