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Yu B, Wang J, He C, Wang W, Tang J, Zheng R, Zhou C, Zhang H, Fu Z, Li Q, Xu J. Cytokine-induced killer cell therapy for modulating regulatory T cells in patients with non-small cell lung cancer. Exp Ther Med 2017; 14:831-840. [PMID: 28673007 DOI: 10.3892/etm.2017.4562] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/10/2017] [Indexed: 12/14/2022] Open
Abstract
Previous studies have reported that regulatory T cells (Tregs), which are physiologically engaged in the maintenance of immunological self-tolerance, have a critical role in the regulation of the antitumor immune response. Targeting Tregs has the potential to augment cancer vaccine approaches. The current study therefore aimed to evaluate the role of cytokine-induced killer (CIK) cell infusion in modulating Tregs in patients with non-small cell lung cancer (NSCLC). A total of 15 patients with advanced NSCLC were treated by an infusion of CIK cells derived from autologous peripheral blood mononuclear cells (PBMCs). By using flow cytometry and liquid chip analysis, subsets of T cells and natural killer (NK) cells in peripheral blood, and plasma cytokine profiles in the treated patients, were analyzed at 2 and 4 weeks after CIK cell infusion. Cytotoxicity of PBMCs (n=15) and NK cells (n=6) isolated from NSCLC patients was evaluated before and after CIK cell therapy. Progression-free survival (PFS) and overall survival (OS) were also assessed. Analysis of the immune cell populations before and after treatment showed a significant increase in NK cells (P<0.05) concomitant with a significant decrease in Tregs (P<0.01) at 2 weeks post-infusion of CIK cells compared with the baseline. NK group 2D receptor (NKG2D) expression on NK cells was also significantly increased at 2 weeks post-infusion compared with the baseline (P<0.05). There was a positive correlation between NKG2D expression and the infusion number of CIK cells (P<0.05). When evaluated at 2 weeks after CIK cell therapy, the cytotoxicity of PBMCs and isolated NK cells was significantly increased compared with the baseline (P<0.01 and P<0.05). Correspondingly, plasma cytokine profiles showed significant enhancement of the following antitumor cytokines: Interferon (IFN)-γ (P<0.05), IFN-γ-inducible protein 10 (P<0.01), tumor necrosis factor-α (P<0.001), granulocyte-macrophage colony-stimulating factor (P<0.01), monocyte chemotactic protein-3 (P<0.01) and interleukin-21 (P<0.05) at 2 weeks post-infusion, compared with the baseline. At the same time, the expression of transforming growth factor-β1, which is primarily produced by Tregs, was significantly decreased compared with the baseline (P<0.05). Median PFS and OS in the CIK cell treatment group were significantly increased compared with the control group (PFS, 9.98 vs. 5.44 months, P=0.038; OS, 24.17 vs. 20.19 months, P=0.048). No severe side-effects were observed during the treatment period. In conclusion, CIK cell therapy was able to suppress Tregs and enhance the antitumor immunity of NK cells in advanced NSCLC patients. Therefore, CIK cell treatment may improve PFS and OS in patients with advanced NSCLC. CIK cell infusion may have therapeutic value for patients with advanced NSCLC, as a treatment that can be combined with chemotherapy and radiotherapy.
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Affiliation(s)
- Baodan Yu
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Junli Wang
- Department of Respiration, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong 518100, P.R. China
| | - Chen He
- Department of Respiratory Medicine, The Affiliated Shenzhen Bao'an Hospital of Southern Medical University, Shenzhen, Guangdong 518101, P.R. China
| | - Wei Wang
- Department of Medical Oncology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, P.R. China
| | - Jianli Tang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Runhui Zheng
- Department of Hematology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Chengzhi Zhou
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Huanhuan Zhang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Zhiping Fu
- Department of Respiratory Medicine, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, Hubei 434020, P.R. China
| | - Qiasheng Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Jun Xu
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
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Moumtzi D, Lampaki S, Zarogoulidis P, Porpodis K, Lagoudi K, Hohenforst-Schmidt W, Pataka A, Tsiouda T, Zissimopoulos A, Lazaridis G, Karavasilis V, Timotheadou H, Barbetakis N, Pavlidis P, Kontakiotis T, Zarogoulidis K. Prognostic factors for long term survival in patients with advanced non-small cell lung cancer. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:161. [PMID: 27275474 DOI: 10.21037/atm.2016.05.13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) represents 85% of all lung cancers. It is estimated that 60% of patients with NSCLC at time of diagnosis have advanced disease. The aim of this study was to investigate clinical and demographic prognostic factors of long term survival in patients with unresectable NSCLC. METHODS We retrospectively reviewed data of 1,156 patients with NSCLC stage IIIB or IV who survived more than 60 days from the time of diagnosis and treated from August 1987 until March 2013 in the Oncology Department of Pulmonary Clinic of the General Hospital Papanikolaou. Initially univariate analysis using the log-rank test was conducted and then multivariate analysis using the proportional hazards model of Cox. Also Kaplan Meier curves were used to describe the distribution of survival times of patients. The level of significance was set at 0.05. RESULTS The mean age at diagnosis was 62 years. About 11.9% of patients were women and 88.1% were male. The majority of cases were adenocarcinomas (42.2%), followed squamous (33%) and finally the large cell (6%). Unlike men, most common histological type among women was adenocarcinoma rather than squamous (63% vs. 10.9%). In univariate analysis statistically significant factors in the progression free survival (PFS) and overall survival (OS) were: weight loss ≥5%, histological type, line 1 drugs, line 1 combination, line 1 cycles and radio lung. Specifically radio lung gives clear survival benefit in the PFS and OS in stage IIIB (P=0.002) and IV (P<0.001). On the other hand, the number of distant metastases in stage IV patients did not affect OS, neither PFS. In addition patients who received platinum and taxane had better PFS (P=0.001) and OS (P<0.001) than those who received platinum without taxane. Also the third drug administration proved futile, since survival (682.06±34.9) (P=0.023) and PFS (434.93±26.93) (P=0.012) of patients who received less than three drugs was significantly larger. Finally, large cell carcinoma recorded the shortest OS and PFS compared with adenocarcinoma (P=0.043 and P=0.016 respectively) and squamous cell carcinoma (P=0.021 and P=0.004 respectively). In multivariate analysis the same predictors were statistically significant except for line 1 drugs. CONCLUSIONS This study confirms the increased incidence of adenocarcinoma in women than in men and the aggressiveness of large cell carcinoma. It also underlines the vitality of factors such as weight loss, radio lung and doublet platinum-based. On the other hand, it excludes significant factors such as gender, age and smoking.
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Affiliation(s)
- Despoina Moumtzi
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Sofia Lampaki
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paul Zarogoulidis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Porpodis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Kalliopi Lagoudi
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Wolfgang Hohenforst-Schmidt
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Athanasia Pataka
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Theodora Tsiouda
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Athanasios Zissimopoulos
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - George Lazaridis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Vasilis Karavasilis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Helen Timotheadou
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Barbetakis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Pavlos Pavlidis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Theodoros Kontakiotis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Zarogoulidis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Medical Clinic I, "Fuerth'' Hospital, University of Erlangen, Fuerth, Germany ; 3 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 4 Oncology Department, "G. Papageorgiou" University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Forensic Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
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