Effectiveness and safety of chemotherapy combined with cytokine-induced killer cell /dendritic cell-cytokine-induced killer cell therapy for treatment of gastric cancer in China: A systematic review and meta-analysis

Ying Mu; Chang-Hui Zhou; Shuang-Feng Chen; Jie Ding; Ying-Xin Zhang; Ya-Pei Yang; Wei-Hua Wang

doi:10.1016/j.jcyt.2016.05.015

Effectiveness and safety of chemotherapy combined with cytokine-induced killer cell /dendritic cell-cytokine-induced killer cell therapy for treatment of gastric cancer in China: A systematic review and meta-analysis

Cytotherapy. 2016 Sep;18(9):1162-77. doi: 10.1016/j.jcyt.2016.05.015. Epub 2016 Jul 12.

Authors

Ying Mu¹, Chang-Hui Zhou², Shuang-Feng Chen², Jie Ding², Ying-Xin Zhang², Ya-Pei Yang², Wei-Hua Wang³

Affiliations

¹ Department of Gastroenterology, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical University, Liaocheng, Shandong Province, China.
² Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical University, Liaocheng, Shandong Province, China.
³ Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng Clinical School, Taishan Medical University, Liaocheng, Shandong Province, China. Electronic address: wangweihualc@163.com.

PMID: 27421742
DOI: 10.1016/j.jcyt.2016.05.015

Abstract

Background: Currently, cytokine-induced killer cells (CIK)/dendritic cell (DC)-CIK-mediated immunotherapy is widely used to treat gastric cancer. However, limited information regarding clinical trials on CIK/DC-CIK therapy is available. Therefore, systemic evaluation of the efficacy and safety of the combination therapy is necessary.

Methods: A meta-analysis involving 1735 patients with gastric cancer was conducted. Before analysis, the study quality and heterogeneity were evaluated. The effects of chemotherapy combined with CIK/DC-CIK on gastric cancer were compared with the effects observed when chemotherapy alone was used. Pooled analysis was performed using RevMan version 5.2 from random or fixed-effect models.

Results: Seventeen trials were included. First, the analysis showed that the combination therapy significantly increased the overall survival rate and disease-free survival rate compared with those in patients treated using chemotherapy alone. The overall response rate (P = 0.002), disease control rate (P = 0.0007), and quality of life improved rate (P = 0.0008) were significantly improved in patients who received combined treatment than in patients who received chemotherapy alone. Second, the percentage of lymphocyte subsets (CD3(+), CD4(+) and CD3(-)CD56(+), CD3(+)CD56(+); P <0.01) and the levels of interleukin-12 and interferon-γ, which reflect immune function, were significantly increased (P <0.05) after the CIK/DC-CIK therapy. Further, carbohydrate antigen tumor markers were significantly reduced compared with the pre-therapy levels. Immunotherapy with CIK/DC-CIK obviously alleviated the adverse events caused by chemotherapy.

Conclusion: The combination of CIK/DC-CIK therapy and chemotherapy was superior in prolonging the survival time, enhancing immune function and alleviating the adverse events caused by chemotherapy.

Keywords: cytokine-induced killer cells; dendritic cells; gastric cancer; immunotherapy; meta-analysis.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Antineoplastic Agents / therapeutic use*
Cell- and Tissue-Based Therapy / methods*
China
Combined Modality Therapy
Cytokine-Induced Killer Cells* / immunology
Dendritic Cells / immunology
Disease-Free Survival
Humans
Immunotherapy / methods
Lymphocyte Subsets
Quality of Life
Stomach Neoplasms / mortality
Stomach Neoplasms / therapy*
Survival Rate
Treatment Outcome

Substances

Antineoplastic Agents