Clinical Study Of The Prostatic Acid Phosphatase-loaded DC Combined With CIK Adoptive Immunotherapy In Advanced HRPC Patients

Objective: Bio-immunotherapy plays an increasingly important role in the treatment of the advanced HRPC on account of the ability of killing tumor cells effectively and minor side effects. The purpose is to investigate the clinical efficacy of prostatic acid phosphatase-loaded DC combined with CIK adoptive immunotherapy in advanced HPRC patients.Methods: This is a retrospective analysis of data of 32 HPRC patients admitted to the Center of Tumor Biotherapy, the second affiliated hospital with Jilin University during April, 2009 to February, 2013. All the patients enrolled missed the opportunity for surgery, chemotherapy and radiotherapy. These patients were allocated to two groups: experimental group(n=16), treated with PAP-DC combined with CIK adoptive immunotherapy; control group(n=16), treated with prostate cancer cells lysate-sensitized DC combined with CIK adoptive immunotherapy. In the control group, a small amount of prostate cancer tissue was taken by needle biopsy of the prostate from the patients, using to prepare the antigen of autologous tumor cells lysate. Peripheral blood mononuclear cells were separated from all the patients, inducing to DC and CIK cells. The two groups respectively use the antigen of PAP and prostate cancer cells line lysate to sensitize DC. Then DC and CIK cells were transfused to the patients in turn of 8-9 days. The changes of lymphocyte subsets of the two groups before and after the treatment were tested by flow cytometry, meanwhile evaluating the curative effect indicators of PSA, objective remission rate, quality of life, survival time and safety. The statistical analysis was achieved by the software of SPSS17.0.Results: Subgroups of T lymphocytes in peripheral blood increased after treatment in both groups. However, the difference between two groups were statistically insignificant(p > 0.05). PSA levels increased at one week following treatment while decreased at one month following treatment in both groups, and the changes at one month following treatment were statistically significant compared with pretherapy(p<0.05),but the difference between two groups were statistically insignificant. For the evaluation of short-term efficacy at three months following treatment, there were 3 cases of PR, 9 cases of SD and 4 cases of PD in the experimental group and 2 cases of PR, 8 cases of SD and 6 cases of PD in the control group. Objective remission rate of the experimental group were higher than the control group(75% vs 62.6%). OS between two groups were statistically insignificant while median time to progression were superior in experimental group than control group(11.4 vs 8.1months). The physical strength(KPS score) improved after treatment, but it is not statistically significant between two groups. No severe adverse effects occurred in both groups and HRPC patients tolerate the treatment well.Conclusions: The clinical efficacy of PAP polypepetide-loaded DC combined with CIK adoptive immunotherapy for the treatment of advanced HRPC patients was no worse than that of prostate cancer cells lysate,making patients having benefit in progression-free survival and well tolerated, this method of treatment is worthwhile for clinical application.