| Objective:DC-CIK is obtained by co-culture of dendritic cells(DC)loaded with autologous tumor antigens with cytokine-induced killer(CIK)cells.The objective of this study is to investigate the effect of adoptive immunotherapy with autologous DCCIK cells on the prognosis of patients with triple-negative breast cancer(TNBC)after surgery,and to evaluate the safety and adverse reactions of DC-CIK cell immunotherapy,and thus to provide a clinical basis for future immunotherapy on TNBC.Methods:To collect the clinical and pathological data from patients who were diagnosed with TNBC and received autologous DC-CIK adoptive immunotherapy in Tianjin Medical University Cancer Institute and Hospital from January 1,2009 to January 1,2015.According to inclusion and exclusion criteria of the study,a total of 147 cases of postoperative stage ?~? patients with TNBC who received adjuvant chemotherapy combined with autologous DC-CIK adoptive immunotherapy were included as the immunotherapy group.The medical records of TNBC patients who were diagnosed and treated at the same time and in the same hospital but did not undergo autologous DC-CIK immunotherapy were collected according to the same inclusion and exclusion criteria.Finally,another 147 patients were included as a control group.From the date of surgery until May 1,2018,or death,a follow-up was performed for all the patients.The overall survival(OS)and the disease-free survival(DFS)of the two groups were compared,besides,clinical adverse reactions were also monitored and evaluated.The Chi-squared tests were adopted to analyse the differences in variables of the two groups from both demographic and clinical characteristics.The Kaplan-Meier method was used to evaluate the survival times and rates distribution.The log-rank test univariate analyses were used to assess the relationship between survival and potential prognostic factors.This is further verified by the multivariate analysis of Cox proportional hazards regression.Also,SPSS 20.0 software is used as a tool to analysis in all performed calculations.Statistical significance marks a two-tailed P<0.05 in all results.Results:The 1-year,3-year,5-year DFS rates of the immunotherapy group and the control group respectively were:99.3% vs.95.9%,91.8% vs.83.7%,and 88.1% vs. 81.3%.With regard to the DFS period,it is shown that the patients in the immunotherapy group experienced significantly longer time than their counterparts in the control group(P=0.047).Statistically,the two groups have no difference in the metastatic sites(P=0.581),the number of sites(P=0.628),or the time of relapese/metastasis(P=0.119).Similarly,the OS time of the immunotherapy group was also longer than those from control group patients(P=0.007),and the 1-year,3-year,5-year OS rates of the immunotherapy group and the control group were: 99.3% vs.98.0%,96.6% vs.91.8%,and 93.4% vs.84.1%,respectively.It is shown that the OS of TNBC patients in earlystage(?,?A stage)group(P=0.018)was extended by DC-CIK treatment.However,for the DFS(P=0.081 and P=0.114,respectively)or the OS of late-stage(IIB,III stage)TNBC patients(P=0.054),there were no similar results drawn from the analysis.In the immunotherapy group,the median courses of DC-CIK treatment were 6 cycles(range:1–26 cycles).Patients undergoing ? 6 cycles of DC-CIK cells therapy had greater DFS(P=0.020)and OS(P=0.040)than DC-CIK-cells-treated patients for less than 6 cycles in a statistical sense.The main adverse reactions were I to II degrees.No intolerable adverse reactions were observed in both groups,and no statistical difference was observed in comparing the adverse events between the two groups.Conclusion:Chemotherapy in combination with DC-CIK immunotherapy could be used to bring the relapse and metastasis rate to a lower level thus effectively extend the duration of survival time of TNBC patients,especially for those at early stages.Additionally,the adverse effects of DC-CIK immunotherapy are slight. |
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