Efficacy of adjuvant immunotherapy with cytokine-induced killer cells in patients with locally advanced gastric cancer

Purpose

To determine the long-term efficacy of adjuvant immunotherapy with autologous cytokine-induced killer (CIK) cells for locally advanced gastric cancer patients.

Experimental design

One hundred and fifty-one patients with stage III/IV gastric cancer who had undergone gastrectomy were enrolled, assigned to two groups (immunotherapy group versus no immunotherapy group/or control group), and followed.

Results

The 5-year overall survival (OS) and 5-year disease-free survival (DFS) rates for immunotherapy versus control group were 32.4 versus 23.4?% (P?=?0.071) and 28.3 versus 10.4?% (P?=?0.044), respectively. For patients with intestinal-type tumors, the 5-year OS and DFS rates were significantly higher for immunotherapy (OS, 46.8 vs. 31.4?% and P?=?0.045; DFS, 42.4 vs. 15.7?% and P?=?0.023). In the immunotherapy group, the mean CD3⁺ level, CD4⁺ level, and CD4⁺/CD8⁺ ratio increased from 50.8, 26.5, and 0.9?%, respectively, at baseline to 62.6, 35.0, and 1.4?%, respectively, 1?week after the first CIK-cell treatment, returned to baseline after 2?months, and maintained a higher level (60.7?±?8.2?%, 34.2?±?7.1?%, and 1.3?±?0.3?%, respectively) 2?months after 3 cycles of immunotherapy.

Conclusions

Adjuvant immunotherapy with CIK cells prolongs DFS in patients with locally advanced gastric cancer and significantly improves OS in patients with intestinal-type tumors. Intestinal-type tumors could be selected as an important indication for CIK-cell therapy. This treatment may help improve T-lymphocyte subset distribution and improve the host??s immune functions, but multiple cycles are necessary for long-term therapeutic efficacy.