Selections of appropriate regimen of high-dose chemotherapy combined with adoptive cellular therapy with dendritic and cytokine-induced killer cells improved progression-free and overall survival in patients with metastatic breast cancers: reargument of such contentious therapeutic preference

• Autores: Jun Ren, Lijun Di, Guohong Song, Jing Yu, Jun Jia, Yulin Zhu, Ying Yan, Hanfang Jiang, Xu Liang, Li Che, Jie Zhang, Fengling Wan, Xiaoli Wang, Xinna Zhou, Herbert Kim Lyerly
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 15, Nº. 10, 2013, págs. 780-788
• Idioma: inglés
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• Resumen

  • Background We hypothesized that combination of dendritic cell (DC) with autologous cytokine-induced killer (CIK) immunotherapy in setting of high-dose chemotherapy (HDC) would be effective for selected metastatic breast cancer (MBC) patients.

    Patients and methods Our previous work showed thiotepa could eradicate breast cancer stem cells. From 2004 to 2009, 79 patients received standard dose chemotherapy (SDC) of 75 mg/m2 docetaxel and 75 mg/m2 thiotepa versus 87 patients of HDC + DC/CIK: 120 mg/m2 docetaxel to mobilize peripheral CD34+ progenitor cells, a sequence of HDC (120 mg/m2 docetaxel, plus 175 mg/m2 thiotepa) + DC/CIK, with or without 400 mg/m2 carboplatin depending upon bone marrow function. The endpoints were response rates (RR), progression-free survival (PFS), and overall survival (OS).

    Results Compared with SDC, PFS and OS were improved in HDC + DC/CIK (median PFS 10.2 vs. 3.7 months, P < 0.001; median OS 33.1 vs. 15.2 months, P < 0.001). Patients of pre-menopausal, HDC as first-line treatment after metastasis, or with visceral metastasis showed prolonged PFS and OS. SDC group also achieved the similar response as previous reports.

    Conclusion Our study demonstrated the novel combination of HDC with DC/CIK to be an effective choice for the selected MBC population, in which choosing appropriate chemo regimens played important roles, and also specific HDC regimen plus DC/CIK immunotherapy showed the clinical benefits compared with chemotherapy alone.