Effectiveness and Safety of Chemotherapy Combined with Dendritic Cells Co-Cultured with Cytokine-Induced Killer Cells in the Treatment of Advanced Non-Small-Cell Lung Cancer: A Systematic Review and Meta-AnalysisReportar como inadecuado




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Background

Lung cancer, particularly non-small-cell lung cancer NSCLC is the leading cause of cancer mortality. Chemotherapy combined dendritic cells co-cultured with cytokine-induced killer cells DC-CIK immunotherapy has been applied in advanced NSCLC patients- treatment, but couldn-t provide consistent beneficial results. Therefore, it is necessary to evaluate the efficiency and safety of combination therapy to promote the application.

Methods

A literature search for randomized controlled trials of NSCLC was conducted in PubMed database. Before meta-analysis was performed, studies were evaluated heterogeneity. Pooled risk ratios RRs were estimated and 95% confidence intervals CIs were calculated using a fixed-effect model. Sensitivity analysis was also performed.

Results

Six eligible trials were enrolled. Efficiency and safety of chemotherapy followed by DC-CIK immunotherapy experimental group and chemotherapy alone control group were compared. 1-year overall survival OS P = 0.02 and progression free survival PFS P = 0.005 in the experimental group were significantly increased compared with the control. Disease control rate DCR P = 0.006 rose significantly in experimental group. However, no significant differences between the two groups were observed in 2-year OS P = 0.21, 2-year PFS P = 0.10, overall response rate ORR P = 0.76 and partial response PR P = 0.22. Temporary fever, anemia, leukopenia and nausea were the four major adverse events AEs treated by chemotherapy. The incidence of anemia, leukopenia and nausea in the experimental group was obviously lower than the control group. Temporary fever rate was higher in experimental group than that in the control, but could be alleviated by taking sufficient rest.

Conclusions

Chemotherapy combined with DC-CIK immunotherapy showed superiority in DCR, 1-year OS and PFS, and no more AEs appeared, however, there was no significant improvement in ORR, PR, 2-year OS and PFS. As a whole, the combination therapy is safer but modest in efficacy for advanced NSCLC patients.



Autor: Rui-xian Han , Xu Liu , Pan Pan, Ying-jie Jia , Jian-chun Yu

Fuente: http://plos.srce.hr/



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