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Published in: Experimental Hematology & Oncology 1/2012

Open Access 01-12-2012 | Methodology

Cytokine-induced killer (CIK) cell therapy for patients with hepatocellular carcinoma: efficacy and safety

Authors: Yue Ma, Ying-Chun Xu, Lei Tang, Zan Zhang, Jian Wang, Hong-Xia Wang

Published in: Experimental Hematology & Oncology | Issue 1/2012

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Abstract

Purpose

To evaluate the efficacy of cytokine-induced killer (CIK) cell therapy in the treatment of hepatocellular carcinoma.

Materials and methods

Randomized phase II and III trials on CIK cell-based therapy were identified by electronic searches using a combination of "hepatocellular carcinoma" and "cytokine-induced killer cells".

Results

The analysis showed significant survival benefit (one-year survival, p < 0.001; two-year survival, p < 0.001; median overall survival, p < 0.001) in favor of CIK-based therapy. Comparison of CIK group versus non-CIK group resulted in a significantly prolonged progression-free survival (PFS) (p < 0.01). A favored disease control rate (DCR) and overall response rate (ORR) were also observed in patients receiving CIK cell therapy (p < 0.01). Meanwhile, patients in the CIK group showed better quality of life (QoL), diminished HBV-DNA content and AFP level (p < 0.01). Comparing T-lymphocyte subsets in peripheral blood, the analysis showed the ratio of CD3+, CD4+, CD4+CD8+ and CD3+CD4+ T cells significantly increased in the CIK group, compared with the non-CIK group (p < 0.01).

Conclusions

CIK cell therapy demonstrated a significant superiority in prolonging the median overall survival, PFS, DCR, ORR and QoL of HCC patients. These results support further larger scale randomized controlled trials for HCC patients with or without the combination of other therapeutic methods.
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Literature
1.
go back to reference Aravalli RN, Steer CJ, Cressman EN: Molecular mechanisms of hepatocellular carcinoma. Hepatology 2008, 48: 2047–2063.PubMedCrossRef Aravalli RN, Steer CJ, Cressman EN: Molecular mechanisms of hepatocellular carcinoma. Hepatology 2008, 48: 2047–2063.PubMedCrossRef
2.
go back to reference Höpfner M, Schuppan D, Scherübl H: Growth factor receptors and related signalling pathways as targets for novel treatment strategies of hepatocellular cancer. World J Gastroenterol 2008, 14: 1–14.PubMedCentralPubMedCrossRef Höpfner M, Schuppan D, Scherübl H: Growth factor receptors and related signalling pathways as targets for novel treatment strategies of hepatocellular cancer. World J Gastroenterol 2008, 14: 1–14.PubMedCentralPubMedCrossRef
3.
go back to reference Avila MA, Berasain C, Sangro B, Prieto J: New therapies for hepatocellular carcinoma. Oncogene 2006, 25: 3866–3884.PubMedCrossRef Avila MA, Berasain C, Sangro B, Prieto J: New therapies for hepatocellular carcinoma. Oncogene 2006, 25: 3866–3884.PubMedCrossRef
4.
go back to reference Poon RT, Fan ST, Ng IO, et al.: Singnificance of resection margin in hepatectomy for hepatocellular carcinoma:a critical reappraisal. Ann Surg 2000, 231: 544–551.PubMedCentralPubMedCrossRef Poon RT, Fan ST, Ng IO, et al.: Singnificance of resection margin in hepatectomy for hepatocellular carcinoma:a critical reappraisal. Ann Surg 2000, 231: 544–551.PubMedCentralPubMedCrossRef
5.
go back to reference Schmidt-Wolf IG, Negrin RS, Kiem HP, et al.: Use of a SCID mouse/human lymphoma model to evaluate cytokine-induced killer cells with potent antitumor cell activity. J Exp Med 1991, 174: 139–149.PubMedCrossRef Schmidt-Wolf IG, Negrin RS, Kiem HP, et al.: Use of a SCID mouse/human lymphoma model to evaluate cytokine-induced killer cells with potent antitumor cell activity. J Exp Med 1991, 174: 139–149.PubMedCrossRef
6.
go back to reference Introna M, Borleri G, Conti E, et al.: Repeated infusions of donor-derived cytokine-induced killer cells in patients relapsing after allogeneic stem cell transplantation: a phase I study. Haematologica 2007, 92: 952–959.PubMedCrossRef Introna M, Borleri G, Conti E, et al.: Repeated infusions of donor-derived cytokine-induced killer cells in patients relapsing after allogeneic stem cell transplantation: a phase I study. Haematologica 2007, 92: 952–959.PubMedCrossRef
7.
go back to reference Li Q, Chang AE: Adoptive T-cell immunotherapy of cancer. Cytokines Cell Mol Ther 1999,5(2):105–117.PubMed Li Q, Chang AE: Adoptive T-cell immunotherapy of cancer. Cytokines Cell Mol Ther 1999,5(2):105–117.PubMed
8.
go back to reference Schmidt-Wolf IG, Lefterova P, Mehta BA, et al.: Phenotypic characterization and identification of effector cells involved in tumor cell recognition of cytokine-induced killer cells. J Exp Hematol 1993,21(13):1673–1679. Schmidt-Wolf IG, Lefterova P, Mehta BA, et al.: Phenotypic characterization and identification of effector cells involved in tumor cell recognition of cytokine-induced killer cells. J Exp Hematol 1993,21(13):1673–1679.
9.
go back to reference Linn YC, Hui KM: Cytokine-induced NK-like T cells: from bench to bedside. J Biomed Biotechnol 2010, 2010: 1–8.CrossRef Linn YC, Hui KM: Cytokine-induced NK-like T cells: from bench to bedside. J Biomed Biotechnol 2010, 2010: 1–8.CrossRef
10.
go back to reference Hontscha C, Borck Y, Zhou H, et al.: Clinical trials on CIK cells: first report of the international registry on CIK cells (IRCC). J Cancer Res Clin Oncol 2010, 137: 305–310.PubMedCrossRef Hontscha C, Borck Y, Zhou H, et al.: Clinical trials on CIK cells: first report of the international registry on CIK cells (IRCC). J Cancer Res Clin Oncol 2010, 137: 305–310.PubMedCrossRef
11.
go back to reference Bonanno G, Iudicone P, Mariotti A, et al.: Thymoglobulin, interferon-γ and interleukin-2 efficiently expand cytokine-induced killer (CIK) cells in clinical-grade cultures. J Transl Med 2010,7(8):129–143.CrossRef Bonanno G, Iudicone P, Mariotti A, et al.: Thymoglobulin, interferon-γ and interleukin-2 efficiently expand cytokine-induced killer (CIK) cells in clinical-grade cultures. J Transl Med 2010,7(8):129–143.CrossRef
12.
go back to reference Introna M, Pievani A, Borleri G, et al.: Feasibility and safety of adoptive immunotherapy with CIK cells after cord blood transplantation. Biol Blood Marrow Transplant 2010,16(11):1603–1607.PubMedCrossRef Introna M, Pievani A, Borleri G, et al.: Feasibility and safety of adoptive immunotherapy with CIK cells after cord blood transplantation. Biol Blood Marrow Transplant 2010,16(11):1603–1607.PubMedCrossRef
13.
go back to reference Wei G, Ni W, Chiao J-W, et al.: A meta-analysis of CAG (cytarabine, aclarubicin, G-CSF) regimen for the treatment of 1029 patients with acute myeloid leukemia and myelodysplastic syndrome. J Hematol Oncol 2011, 4: 46.PubMedCentralPubMedCrossRef Wei G, Ni W, Chiao J-W, et al.: A meta-analysis of CAG (cytarabine, aclarubicin, G-CSF) regimen for the treatment of 1029 patients with acute myeloid leukemia and myelodysplastic syndrome. J Hematol Oncol 2011, 4: 46.PubMedCentralPubMedCrossRef
15.
go back to reference Yates JW, Chalmer B, McKegney FP: Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer 1980, 45: 2220–2224.PubMedCrossRef Yates JW, Chalmer B, McKegney FP: Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer 1980, 45: 2220–2224.PubMedCrossRef
16.
go back to reference Zhang K, Zuo Q, Luo R-C, et al.: The CIK cells adoptive immunotherapy on immune function in patients with liver cancer after TACE effect. J Guangdong Med 2007,28(9):1487–1488. Zhang K, Zuo Q, Luo R-C, et al.: The CIK cells adoptive immunotherapy on immune function in patients with liver cancer after TACE effect. J Guangdong Med 2007,28(9):1487–1488.
17.
go back to reference Guo P, Lu H, Dong S-X, et al.: The clinical reserach of CIK cells combined interventional therapy for advanced liver cancer. Chin Hosp Pharm J 2007,27(11):1565–1567. Guo P, Lu H, Dong S-X, et al.: The clinical reserach of CIK cells combined interventional therapy for advanced liver cancer. Chin Hosp Pharm J 2007,27(11):1565–1567.
18.
go back to reference Hao M-Z, Cheng Q, Ye Y-B, et al.: Transcatheter arterial chemoembolization combined with cytokine induced killers in treatment of hepatocellular carcinoma. Chin J Cancer Biother 2006,13(4):303–305. Hao M-Z, Cheng Q, Ye Y-B, et al.: Transcatheter arterial chemoembolization combined with cytokine induced killers in treatment of hepatocellular carcinoma. Chin J Cancer Biother 2006,13(4):303–305.
19.
go back to reference Hao MZ, Lin HL, Chen Q, et al.: Efficacy of transcatheter arterial chemoembolization combined with cytokine-induced killer cell therapy on hepatocellular carcinoma: a comparative study. Chin J Cancer 2010, 29: 172–177.PubMedCrossRef Hao MZ, Lin HL, Chen Q, et al.: Efficacy of transcatheter arterial chemoembolization combined with cytokine-induced killer cell therapy on hepatocellular carcinoma: a comparative study. Chin J Cancer 2010, 29: 172–177.PubMedCrossRef
20.
go back to reference Weng DS, Zhou J, Zhou QM, et al.: Minimally invasive treatment combined with cytokine-induced killer cells therapy lower the short-term recurrence rates of hepatocellular carcinomas. J Immunother 2008, 31: 63–71.PubMedCrossRef Weng DS, Zhou J, Zhou QM, et al.: Minimally invasive treatment combined with cytokine-induced killer cells therapy lower the short-term recurrence rates of hepatocellular carcinomas. J Immunother 2008, 31: 63–71.PubMedCrossRef
21.
go back to reference Zhao M, Wu PH, Zeng YX, et al.: Cytokine-induced killer cell fusion to lower recurrence of hepatocellular carcinoma after transcatheter arterial chemoembolization sequentially combined with radiofrequency ablation: a randomized trial. Zhonghua Yi Xue Za Zhi 2006, 86: 1823–1828.PubMed Zhao M, Wu PH, Zeng YX, et al.: Cytokine-induced killer cell fusion to lower recurrence of hepatocellular carcinoma after transcatheter arterial chemoembolization sequentially combined with radiofrequency ablation: a randomized trial. Zhonghua Yi Xue Za Zhi 2006, 86: 1823–1828.PubMed
22.
go back to reference Pan CC, Huang ZL, Li W, et al.: Serum alpha-fetoprotein measurement in predicting clinical outcome related to autologous cytokine-induced killer cells in patients with hepatocellular carcinoma undergone minimally invasive therapy. Chin J Cancer 2010, 29: 596–602.PubMedCrossRef Pan CC, Huang ZL, Li W, et al.: Serum alpha-fetoprotein measurement in predicting clinical outcome related to autologous cytokine-induced killer cells in patients with hepatocellular carcinoma undergone minimally invasive therapy. Chin J Cancer 2010, 29: 596–602.PubMedCrossRef
23.
go back to reference Wan C, Luo RC, Cui F, et al.: Transcatheter arterial chemoembolization plus sequential radiofrequency ablation combined with cytokine-induced killer cell therapy for hepatocellular carcinoma. J Pract Med 2008,24(8):1321–1323. Wan C, Luo RC, Cui F, et al.: Transcatheter arterial chemoembolization plus sequential radiofrequency ablation combined with cytokine-induced killer cell therapy for hepatocellular carcinoma. J Pract Med 2008,24(8):1321–1323.
24.
go back to reference Hui D, Qiang L, Jian W, et al.: A randomized, controlled trial of postoperative adjuvant cytokine-induced killer cells immunotherapy after radical resection of hepatocellular carcinoma. J Dig Liver Dis 2009, 41: 36–41.CrossRef Hui D, Qiang L, Jian W, et al.: A randomized, controlled trial of postoperative adjuvant cytokine-induced killer cells immunotherapy after radical resection of hepatocellular carcinoma. J Dig Liver Dis 2009, 41: 36–41.CrossRef
25.
go back to reference Lu B, Li DY, Zhang X: The observation of CIK cells on the survival rate of liver cancer patients. J Med Forum 2008,29(24):69–70. Lu B, Li DY, Zhang X: The observation of CIK cells on the survival rate of liver cancer patients. J Med Forum 2008,29(24):69–70.
26.
go back to reference Yu WC, Ye YB, Zhou D, et al.: Effect of postoperative transcatheter arteial chemoembolization combined with cytokine-induced killer immunotherapy of recurrence and suvival rate of hepatocellular carcinoma patients. J Minim Invasive Med 2009,4(5):459–461. Yu WC, Ye YB, Zhou D, et al.: Effect of postoperative transcatheter arteial chemoembolization combined with cytokine-induced killer immunotherapy of recurrence and suvival rate of hepatocellular carcinoma patients. J Minim Invasive Med 2009,4(5):459–461.
27.
go back to reference Zhang ZN, Xu YM, Xu FX, et al.: Clinical study on the treatment of advanced hepatocellular carcinoma by CIK cell. J Southeast Natl Defense Med 2006,8(2):84–87. Zhang ZN, Xu YM, Xu FX, et al.: Clinical study on the treatment of advanced hepatocellular carcinoma by CIK cell. J Southeast Natl Defense Med 2006,8(2):84–87.
28.
go back to reference Shi Y, Gao CJ, Dong SL, et al.: Cytokine-induced killer cell for interventionla chemotherapy of hepatocellular carcinoma. J Intervent Radiol 2007,16(4):235–239. Shi Y, Gao CJ, Dong SL, et al.: Cytokine-induced killer cell for interventionla chemotherapy of hepatocellular carcinoma. J Intervent Radiol 2007,16(4):235–239.
29.
go back to reference Sun K, Wang L, Zhang YY: Dendritic Cell as Therapeutic Vaccines against Tumors and Its Role in Therapy for Hepatocellular Carcinoma. Cell Mol Immunol 2006,3(3):197–203.PubMed Sun K, Wang L, Zhang YY: Dendritic Cell as Therapeutic Vaccines against Tumors and Its Role in Therapy for Hepatocellular Carcinoma. Cell Mol Immunol 2006,3(3):197–203.PubMed
30.
go back to reference Verneris MR, Karami M, Baker J, et al.: Role of NKG2D signaling in the cytotoxicity of activated and expanded CD8 + T cells. Blood 2004, 103: 3065–3072.PubMedCrossRef Verneris MR, Karami M, Baker J, et al.: Role of NKG2D signaling in the cytotoxicity of activated and expanded CD8 + T cells. Blood 2004, 103: 3065–3072.PubMedCrossRef
31.
go back to reference Schmidt-Wolf GD, Negrin RS, Schmidt-Wolf IG: Activated T cells and cytokine-induced CD3 + CD56+ killer cells. Ann Hematol 1997,74(2):51–56.PubMedCrossRef Schmidt-Wolf GD, Negrin RS, Schmidt-Wolf IG: Activated T cells and cytokine-induced CD3 + CD56+ killer cells. Ann Hematol 1997,74(2):51–56.PubMedCrossRef
32.
go back to reference Hada H, Arima T, Nagashima H, et al.: Hepatitis B virus DNA in human hepatocellular carcinoma: is the integration of hepatitis B virus DNA really carcinogenic? Gastroenterol Japan 1986,21(6):594–600. Hada H, Arima T, Nagashima H, et al.: Hepatitis B virus DNA in human hepatocellular carcinoma: is the integration of hepatitis B virus DNA really carcinogenic? Gastroenterol Japan 1986,21(6):594–600.
33.
go back to reference Wei GQ, Ni WM, Chiao JW, et al.: Targeting insulin-like growth factor axis in hepatocellular carcinoma. J Hematol Oncol 2011, 4: 30.CrossRef Wei GQ, Ni WM, Chiao JW, et al.: Targeting insulin-like growth factor axis in hepatocellular carcinoma. J Hematol Oncol 2011, 4: 30.CrossRef
34.
go back to reference Cedrone A, Covino M, Caturelli E, et al.: Utility of alpha - fetoprotein (AFP) in the screening of patients with virus - related chronic liver disease: does different viral etiology influence AFP levels in HCC? A study in 350 western patients. Hepatogastroenterology 2000,47(36):1654–1658.PubMed Cedrone A, Covino M, Caturelli E, et al.: Utility of alpha - fetoprotein (AFP) in the screening of patients with virus - related chronic liver disease: does different viral etiology influence AFP levels in HCC? A study in 350 western patients. Hepatogastroenterology 2000,47(36):1654–1658.PubMed
35.
go back to reference Soresi M, Magliarisi C, Campagna P, et al.: Usefulness of alpha- fetoprotein in the diagnosis of hepatocellular carcinoma. Anticancer Res 2003,23(2):1747–1753.PubMed Soresi M, Magliarisi C, Campagna P, et al.: Usefulness of alpha- fetoprotein in the diagnosis of hepatocellular carcinoma. Anticancer Res 2003,23(2):1747–1753.PubMed
36.
go back to reference Johnson PJ: The role of serum alpha - fetoprotein estimation in the diagnosis and management of hepatocellular carcinoma. Clin Liver Dis 2001,5(1):145–159.PubMedCrossRef Johnson PJ: The role of serum alpha - fetoprotein estimation in the diagnosis and management of hepatocellular carcinoma. Clin Liver Dis 2001,5(1):145–159.PubMedCrossRef
37.
go back to reference Kastelan Z, Lukac J, Derezic D, et al.: Lymphocyte subsets, lymphocyte reactivity to mitogens, NK cell activity and neutrphil and monocyte phagocytic functions in patients with bladder carcinoma. Anticancer Res 2003, 23: 5185–5189.PubMed Kastelan Z, Lukac J, Derezic D, et al.: Lymphocyte subsets, lymphocyte reactivity to mitogens, NK cell activity and neutrphil and monocyte phagocytic functions in patients with bladder carcinoma. Anticancer Res 2003, 23: 5185–5189.PubMed
38.
go back to reference Attallah AM, Tabll AA, El-Sadny M, et al.: Dysregulation of blood lymphocyte subsets and natural killer cells in schistosomal liver cirrhosis and hepatocellular carcinoma. Clin Exp Med 2003, 3: 181–185.PubMedCrossRef Attallah AM, Tabll AA, El-Sadny M, et al.: Dysregulation of blood lymphocyte subsets and natural killer cells in schistosomal liver cirrhosis and hepatocellular carcinoma. Clin Exp Med 2003, 3: 181–185.PubMedCrossRef
39.
go back to reference Cao JP, Jiang ZM, Zhang XC, et al.: The proliferation, phenotype change and anti-tumor activity of cytokine induced killer cell. J Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2005,21(5):583–586. Cao JP, Jiang ZM, Zhang XC, et al.: The proliferation, phenotype change and anti-tumor activity of cytokine induced killer cell. J Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2005,21(5):583–586.
40.
go back to reference Kambe N, Kambe M, Chang HW, et al.: An improved proved procedure for the development of human mast cells from dispersed fetal liver cells in serum-free culture medium. J Immounol Methods 2000,240(1–2):101–110.CrossRef Kambe N, Kambe M, Chang HW, et al.: An improved proved procedure for the development of human mast cells from dispersed fetal liver cells in serum-free culture medium. J Immounol Methods 2000,240(1–2):101–110.CrossRef
Metadata
Title
Cytokine-induced killer (CIK) cell therapy for patients with hepatocellular carcinoma: efficacy and safety
Authors
Yue Ma
Ying-Chun Xu
Lei Tang
Zan Zhang
Jian Wang
Hong-Xia Wang
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Experimental Hematology & Oncology / Issue 1/2012
Electronic ISSN: 2162-3619
DOI
https://doi.org/10.1186/2162-3619-1-11

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