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Published in: Cancer Immunology, Immunotherapy 11/2012

01-11-2012 | Original article

Autologous cytokine-induced killer cell immunotherapy in lung cancer: a phase II clinical study

Authors: Runmei Li, Changli Wang, Liang Liu, Chunjuan Du, Shui Cao, Jinpu Yu, Shizhen Emily Wang, Xishan Hao, Xiubao Ren, Hui Li

Published in: Cancer Immunology, Immunotherapy | Issue 11/2012

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Abstract

Objective

Cytokine-induced killer (CIK) cells have the ability to kill tumor in vitro and in vivo. This study was designed to evaluate the clinical efficacy of CIK cell immunotherapy following regular chemotherapy in patients with non-small cell lung cancer (NSCLC) after surgery.

Methods

A paired study, with 87 stage I–IV NSCLC patients in each group, was performed. Patients received either chemotherapy (arm 2) or chemotherapy in combination with autologous CIK cell immunotherapy (arm 1). Progression-free survival (PFS) and overall survival (OS) were evaluated.

Results

Of the 87 paired patients, 50 had early-stage disease (stage I–IIIA) and 37 had advanced-stage disease (stage IIIB–IV). Among early-stage patients, the distribution of 3-year PFS rate and median PFS time showed no statistical difference between the two groups (p = 0.259 and 0.093, respectively); however, the 3-year OS rate and median OS time in arm 1 were significantly higher than those in arm 2 (82 vs. 66 %; p = 0.049 and 73 vs. 53 months; p = 0.006, respectively). Among the advanced-stage patients, the 3-year PFS and OS rates of arm 1 were significantly higher than those of arm 2 (6 vs. 3 %; p < 0.001 and 31 vs. 3 %; p < 0.001, respectively); the median PFS and OS times in arm 1 were also significantly longer than those in arm 2 (13 vs. 6 months; p = 0.001 and 24 vs. 10 months; p < 0.001, respectively). Multivariate analyses indicated that the frequency of CIK cell immunotherapy was significantly associated with prolonged PFS (HR = 0.91; 95 % CI 0.85–0.98; p = 0.012) and OS (HR = 0.83; 95 % CI, 0.74–0.93; p = 0.001) in the arm 1.

Conclusions

The data suggested that CIK cell immunotherapy could improve the efficacy of conventional chemotherapy in NSCLC patients, and increased frequency of CIK cell treatment could further enhance the beneficial effects. A multi-center randomized trial is being carried out in our hospital to further validate these findings.
Literature
1.
go back to reference Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90PubMedCrossRef Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90PubMedCrossRef
2.
go back to reference Juergens R, Brahmer J (2007) Targeting the epidermal growth factor receptor in non-small-cell lung cancer: who, which, when, and how? Curr Oncol Rep 9:255–264PubMedCrossRef Juergens R, Brahmer J (2007) Targeting the epidermal growth factor receptor in non-small-cell lung cancer: who, which, when, and how? Curr Oncol Rep 9:255–264PubMedCrossRef
3.
go back to reference Stinchcombe TE, Socinski MA (2009) Current treatments for advanced stage non-small cell lung cancer. Proc Am Thorac Soc 6:233–241PubMedCrossRef Stinchcombe TE, Socinski MA (2009) Current treatments for advanced stage non-small cell lung cancer. Proc Am Thorac Soc 6:233–241PubMedCrossRef
4.
go back to reference Chemotherapy in non-small cell lung cancer (1995) a meta-analysis using updated data on individual patients from 52 randomised clinical trials. Non-small cell lung cancer collaborative group. BMJ 311:899–909CrossRef Chemotherapy in non-small cell lung cancer (1995) a meta-analysis using updated data on individual patients from 52 randomised clinical trials. Non-small cell lung cancer collaborative group. BMJ 311:899–909CrossRef
5.
go back to reference Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J et al (2002) Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 346:92–98PubMedCrossRef Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J et al (2002) Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 346:92–98PubMedCrossRef
6.
go back to reference Crino L, Dansin E, Garrido P, Griesinger F, Laskin J, Pavlakis N et al (2010) Safety and efficacy of first-line bevacizumab-based therapy in advanced non-squamous non-small cell lung cancer (SAiL, MO19390): a phase 4 study. Lancet Oncol 11:733–740PubMedCrossRef Crino L, Dansin E, Garrido P, Griesinger F, Laskin J, Pavlakis N et al (2010) Safety and efficacy of first-line bevacizumab-based therapy in advanced non-squamous non-small cell lung cancer (SAiL, MO19390): a phase 4 study. Lancet Oncol 11:733–740PubMedCrossRef
7.
go back to reference Scagliotti G, Novello S, von Pawel J, Reck M, Pereira JR, Thomas M et al (2010) Phase III study of carboplatin and paclitaxel alone or with sorafenib in advanced non-small-cell lung cancer. J Clin Oncol 28:1835–1842PubMedCrossRef Scagliotti G, Novello S, von Pawel J, Reck M, Pereira JR, Thomas M et al (2010) Phase III study of carboplatin and paclitaxel alone or with sorafenib in advanced non-small-cell lung cancer. J Clin Oncol 28:1835–1842PubMedCrossRef
8.
go back to reference Heymach JV, Johnson BE, Prager D, Csada E, Roubec J, Pesek M et al (2007) Randomized, placebo-controlled phase II study of vandetanib plus docetaxel in previously treated non small-cell lung cancer. J Clin Oncol 25:4270–4277PubMedCrossRef Heymach JV, Johnson BE, Prager D, Csada E, Roubec J, Pesek M et al (2007) Randomized, placebo-controlled phase II study of vandetanib plus docetaxel in previously treated non small-cell lung cancer. J Clin Oncol 25:4270–4277PubMedCrossRef
9.
go back to reference Hontscha C, Borck Y, Zhou H, Messmer D, Schmidt-Wolf IG (2011) Clinical trials on CIK cells: first report of the international registry on CIK cells (IRCC). J Cancer Res Clin Oncol 137:305–310PubMedCrossRef Hontscha C, Borck Y, Zhou H, Messmer D, Schmidt-Wolf IG (2011) Clinical trials on CIK cells: first report of the international registry on CIK cells (IRCC). J Cancer Res Clin Oncol 137:305–310PubMedCrossRef
10.
go back to reference Stroncek D, Berlyne D, Fox B, Gee A, Heimfeld S, Lindblad R et al (2010) Developments in clinical cell therapy. Cytotherapy 12:425–428PubMedCrossRef Stroncek D, Berlyne D, Fox B, Gee A, Heimfeld S, Lindblad R et al (2010) Developments in clinical cell therapy. Cytotherapy 12:425–428PubMedCrossRef
12.
go back to reference Rosenberg S (1985) Lymphokine-activated killer cells: a new approach to immunotherapy of cancer. J Natl Cancer Inst 75:595–603PubMed Rosenberg S (1985) Lymphokine-activated killer cells: a new approach to immunotherapy of cancer. J Natl Cancer Inst 75:595–603PubMed
13.
go back to reference Rosenberg SA, Spiess P, Lafreniere R (1986) A new approach to the adoptive immunotherapy of cancer with tumor-infiltrating lymphocytes. Science 233:1318–1321PubMedCrossRef Rosenberg SA, Spiess P, Lafreniere R (1986) A new approach to the adoptive immunotherapy of cancer with tumor-infiltrating lymphocytes. Science 233:1318–1321PubMedCrossRef
14.
go back to reference Yun YS, Hargrove ME, Ting CC (1989) In vivo antitumor activity of anti-CD3-induced activated killer cells. Cancer Res 49:4770–4774PubMed Yun YS, Hargrove ME, Ting CC (1989) In vivo antitumor activity of anti-CD3-induced activated killer cells. Cancer Res 49:4770–4774PubMed
15.
go back to reference Shablak A, Hawkins RE, Rothwell DG, Elkord E (2009) T cell-based immunotherapy of metastatic renal cell carcinoma: modest success and future perspective. Clin Cancer Res 15:6503–6510PubMedCrossRef Shablak A, Hawkins RE, Rothwell DG, Elkord E (2009) T cell-based immunotherapy of metastatic renal cell carcinoma: modest success and future perspective. Clin Cancer Res 15:6503–6510PubMedCrossRef
16.
go back to reference Schmidt-Wolf IG, Negrin RS, Kiem HP, Blume KG, Weissman IL (1991) Use of a SCID mouse/human lymphoma model to evaluate cytokine-induced killer cells with potent antitumor cell activity. J Exp Med 174:139–149PubMedCrossRef Schmidt-Wolf IG, Negrin RS, Kiem HP, Blume KG, Weissman IL (1991) Use of a SCID mouse/human lymphoma model to evaluate cytokine-induced killer cells with potent antitumor cell activity. J Exp Med 174:139–149PubMedCrossRef
17.
go back to reference Schmidt-Wolf IG, Lefterova P, Mehta BA, Fernandez LP, Huhn D, Blume KG et al (1993) Phenotypic characterization and identification of effector cells involved in tumor cell recognition of cytokine-induced killer cells. Exp Hematol 21:1673–1679PubMed Schmidt-Wolf IG, Lefterova P, Mehta BA, Fernandez LP, Huhn D, Blume KG et al (1993) Phenotypic characterization and identification of effector cells involved in tumor cell recognition of cytokine-induced killer cells. Exp Hematol 21:1673–1679PubMed
18.
go back to reference Jazieh AR, Bamefleh H, Demirkazik A, Gaafar RM, Geara FB, Javaid M et al (2010) Modification and implementation of NCCN guidelines on non-small cell lung cancer in the Middle East and North Africa region. J Natl Compr Canc Netw 8(Suppl 3):S16–S21PubMed Jazieh AR, Bamefleh H, Demirkazik A, Gaafar RM, Geara FB, Javaid M et al (2010) Modification and implementation of NCCN guidelines on non-small cell lung cancer in the Middle East and North Africa region. J Natl Compr Canc Netw 8(Suppl 3):S16–S21PubMed
19.
go back to reference Tsuchida Y, Therasse P (2001) Response evaluation criteria in solid tumors (RECIST): new guidelines. Med Pediatr Oncol 37:1–3PubMedCrossRef Tsuchida Y, Therasse P (2001) Response evaluation criteria in solid tumors (RECIST): new guidelines. Med Pediatr Oncol 37:1–3PubMedCrossRef
20.
go back to reference Ren X, Yu J, Liu H, Zhang P, An X, Zhang N et al (2006) Th1 bias in PBMC induced by multicycles of auto-CIKs infusion in malignant solid tumor patients. Cancer Biother Radiopharm 21:22–33PubMedCrossRef Ren X, Yu J, Liu H, Zhang P, An X, Zhang N et al (2006) Th1 bias in PBMC induced by multicycles of auto-CIKs infusion in malignant solid tumor patients. Cancer Biother Radiopharm 21:22–33PubMedCrossRef
21.
go back to reference Li H, Wang C, Yu J, Cao S, Wei F, Zhang W et al (2009) Dendritic cell-activated cytokine-induced killer cells enhance the anti-tumor effect of chemotherapy on non-small cell lung cancer in patients after surgery. Cytotherapy 11:1076–1083PubMedCrossRef Li H, Wang C, Yu J, Cao S, Wei F, Zhang W et al (2009) Dendritic cell-activated cytokine-induced killer cells enhance the anti-tumor effect of chemotherapy on non-small cell lung cancer in patients after surgery. Cytotherapy 11:1076–1083PubMedCrossRef
22.
go back to reference Liang Liu, Weihong Zhang, Xiuying Qi, et al. (2012) Randomized study of autologous cytokine-induced killer cell immunotherapy in metastatic renal carcinoma. Clin Cancer Res. January 24; Published Online First Liang Liu, Weihong Zhang, Xiuying Qi, et al. (2012) Randomized study of autologous cytokine-induced killer cell immunotherapy in metastatic renal carcinoma. Clin Cancer Res. January 24; Published Online First
23.
go back to reference Kakimi K, Nakajima J, Wada H (2009) Active specific immunotherapy and cell-transfer therapy for the treatment of non-small cell lung cancer. Lung Cancer 65:1–8PubMedCrossRef Kakimi K, Nakajima J, Wada H (2009) Active specific immunotherapy and cell-transfer therapy for the treatment of non-small cell lung cancer. Lung Cancer 65:1–8PubMedCrossRef
24.
go back to reference Grimm EA, Mazumder A, Zhang HZ, Rosenberg SA (1982) Lymphokine-activated killer cell phenomenon. Lysis of natural killer-resistant fresh solid tumor cells by interleukin 2-activated autologous human peripheral blood lymphocytes. J Exp Med 155:1823–1841PubMedCrossRef Grimm EA, Mazumder A, Zhang HZ, Rosenberg SA (1982) Lymphokine-activated killer cell phenomenon. Lysis of natural killer-resistant fresh solid tumor cells by interleukin 2-activated autologous human peripheral blood lymphocytes. J Exp Med 155:1823–1841PubMedCrossRef
25.
go back to reference Whiteside TL, Miescher S, Hurlimann J, Moretta L, von Fliedner V (1986) Separation, phenotyping and limiting dilution analysis of T-lymphocytes infiltrating human solid tumors. Int J Cancer 37:803–811PubMedCrossRef Whiteside TL, Miescher S, Hurlimann J, Moretta L, von Fliedner V (1986) Separation, phenotyping and limiting dilution analysis of T-lymphocytes infiltrating human solid tumors. Int J Cancer 37:803–811PubMedCrossRef
26.
go back to reference Muul LM, Spiess PJ, Director EP, Rosenberg SA (1987) Identification of specific cytolytic immune responses against autologous tumor in humans bearing malignant melanoma. J Immunol 138:989–995PubMed Muul LM, Spiess PJ, Director EP, Rosenberg SA (1987) Identification of specific cytolytic immune responses against autologous tumor in humans bearing malignant melanoma. J Immunol 138:989–995PubMed
27.
go back to reference Karimi M, Cao TM, Baker JA, Verneris MR, Soares L, Negrin RS (2005) Silencing human NKG2D, DAP10, and DAP12 reduces cytotoxicity of activated CD8 + T cells and NK cells. J Immunol 175:7819–7828PubMed Karimi M, Cao TM, Baker JA, Verneris MR, Soares L, Negrin RS (2005) Silencing human NKG2D, DAP10, and DAP12 reduces cytotoxicity of activated CD8 + T cells and NK cells. J Immunol 175:7819–7828PubMed
28.
go back to reference Verneris MR, Karami M, Baker J, Jayaswal A, Negrin RS (2004) Role of NKG2D signaling in the cytotoxicity of activated and expanded CD8 + T cells. Blood 103:3065–3072PubMedCrossRef Verneris MR, Karami M, Baker J, Jayaswal A, Negrin RS (2004) Role of NKG2D signaling in the cytotoxicity of activated and expanded CD8 + T cells. Blood 103:3065–3072PubMedCrossRef
29.
go back to reference Nishimura R, Baker J, Beilhack A, Zeiser R, Olson JA, Sega EI et al (2008) In vivo trafficking and survival of cytokine-induced killer cells resulting in minimal GVHD with retention of antitumor activity. Blood 112:2563–2574PubMedCrossRef Nishimura R, Baker J, Beilhack A, Zeiser R, Olson JA, Sega EI et al (2008) In vivo trafficking and survival of cytokine-induced killer cells resulting in minimal GVHD with retention of antitumor activity. Blood 112:2563–2574PubMedCrossRef
30.
go back to reference Thorne SH, Negrin RS, Contag CH (2006) Synergistic antitumor effects of immune cell-viral biotherapy. Science 311:1780–1784PubMedCrossRef Thorne SH, Negrin RS, Contag CH (2006) Synergistic antitumor effects of immune cell-viral biotherapy. Science 311:1780–1784PubMedCrossRef
31.
go back to reference Marin V, Dander E, Biagi E, Introna M, Fazio G, Biondi A et al (2006) Characterization of in vitro migratory properties of anti-CD19 chimeric receptor-redirected CIK cells for their potential use in B-ALL immunotherapy. Exp Hematol 34:1219–1229PubMedCrossRef Marin V, Dander E, Biagi E, Introna M, Fazio G, Biondi A et al (2006) Characterization of in vitro migratory properties of anti-CD19 chimeric receptor-redirected CIK cells for their potential use in B-ALL immunotherapy. Exp Hematol 34:1219–1229PubMedCrossRef
32.
go back to reference Takayama T, Sekine T, Makuuchi M, Yamasaki S, Kosuge T, Yamamoto J et al (2000) Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomised trial. Lancet 356:802–807PubMedCrossRef Takayama T, Sekine T, Makuuchi M, Yamasaki S, Kosuge T, Yamamoto J et al (2000) Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomised trial. Lancet 356:802–807PubMedCrossRef
33.
go back to reference Schmidt-Wolf IG, Finke S, Trojaneck B, Denkena A, Lefterova P, Schwella N et al (1999) Phase I clinical study applying autologous immunological effector cells transfected with the interleukin-2 gene in patients with metastatic renal cancer, colorectal cancer and lymphoma. Br J Cancer 81:1009–1016PubMedCrossRef Schmidt-Wolf IG, Finke S, Trojaneck B, Denkena A, Lefterova P, Schwella N et al (1999) Phase I clinical study applying autologous immunological effector cells transfected with the interleukin-2 gene in patients with metastatic renal cancer, colorectal cancer and lymphoma. Br J Cancer 81:1009–1016PubMedCrossRef
34.
go back to reference Li H, Yu JP, Cao S, Wei F, Zhang P, An XM et al (2007) CD4 +CD25 + regulatory T cells decreased the antitumor activity of cytokine-induced killer (CIK) cells of lung cancer patients. J Clin Immunol 27:317–326PubMedCrossRef Li H, Yu JP, Cao S, Wei F, Zhang P, An XM et al (2007) CD4 +CD25 + regulatory T cells decreased the antitumor activity of cytokine-induced killer (CIK) cells of lung cancer patients. J Clin Immunol 27:317–326PubMedCrossRef
35.
go back to reference Wu C, Jiang J, Shi L, Xu N (2008) Prospective study of chemotherapy in combination with cytokine-induced killer cells in patients suffering from advanced non-small cell lung cancer. Anticancer Res 28:3997–4002PubMed Wu C, Jiang J, Shi L, Xu N (2008) Prospective study of chemotherapy in combination with cytokine-induced killer cells in patients suffering from advanced non-small cell lung cancer. Anticancer Res 28:3997–4002PubMed
36.
go back to reference Kantoff PW, Schuetz TJ, Blumenstein BA, Glode LM, Bilhartz DL, Wyand M et al (2010) Overall survival analysis of a phase II randomized controlled trial of a poxviral-based PSA-targeted immunotherapy in metastatic castration-resistant prostate cancer. J Clin Oncol 28:1099–1105PubMedCrossRef Kantoff PW, Schuetz TJ, Blumenstein BA, Glode LM, Bilhartz DL, Wyand M et al (2010) Overall survival analysis of a phase II randomized controlled trial of a poxviral-based PSA-targeted immunotherapy in metastatic castration-resistant prostate cancer. J Clin Oncol 28:1099–1105PubMedCrossRef
37.
go back to reference Hoos A, Eggermont AM, Janetzki S, Hodi FS, Ibrahim R, Anderson A et al (2010) Improved endpoints for cancer immunotherapy trials. J Natl Cancer Inst 102:1388–1397PubMedCrossRef Hoos A, Eggermont AM, Janetzki S, Hodi FS, Ibrahim R, Anderson A et al (2010) Improved endpoints for cancer immunotherapy trials. J Natl Cancer Inst 102:1388–1397PubMedCrossRef
Metadata
Title
Autologous cytokine-induced killer cell immunotherapy in lung cancer: a phase II clinical study
Authors
Runmei Li
Changli Wang
Liang Liu
Chunjuan Du
Shui Cao
Jinpu Yu
Shizhen Emily Wang
Xishan Hao
Xiubao Ren
Hui Li
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Cancer Immunology, Immunotherapy / Issue 11/2012
Print ISSN: 0340-7004
Electronic ISSN: 1432-0851
DOI
https://doi.org/10.1007/s00262-012-1260-2

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