Autologous cytokine-induced killer cells combined with chemotherapy in the treatment of advanced colorectal cancer: a randomized control study

Objective

To evaluate the efficacy of autologous cytokine-induced killer (CIK) cells transfusion combined with chemotherapy in patients suffered from advanced colorectal cancer.

Methods

Sixty untreated patients with advanced colorectal cancer were randomly divided into two groups. The 30 patients in the control group received chemotherapy with the regimen of xeloda plus oxiplatin (XELOX). The 30 patients in the trial group were treated with chemotherapy (XELOX) in combination with autologous CIK cell transfusion. T-lymphocyte subgroups were separated and measured by flow cytometry quality of life (QOL) was determined by EORTC QLQ-C30. The short-term curative effect was evaluated via imaging examinations. The patients’ median progression free survival time was estimated by Kaplan-Meier.

Results

The T-lymphocyte immune activity was improved in patients received autologous CIK cell transfusion than those treated with chemotherapy alone. The subgroup of CD3⁺ CD56⁺ T lymphocyte was significantly increased (4.28 ± 0.45 vs 10.14 ± 1.02, P = 0.01). Short-term efficacy evaluation revealed that there was no significant difference in terms of objective response rate (ORR) between the two groups, but the disease control rate (DCR) was markedly increased (86.7% vs 56.7%, P = 0.020) in the group treated by chemotherapy plus CIK cells compared to the group treated with chemotherapy alone. The progression free survival time was 8.64 months ( 95% CI 6.25–9.75 months) in control group and 10.15 months (95% CI 7.48–12.52 months) in trial group. Compared to patients in control group, the patients in trial group had significantly longer progression-free survival (P = 0.046). The QOL assessment suggested the QOL in trial group was obviously improved than that in the control group. Compared with the control group, patients treated with autologous CIK cell transfusion scored more in the area of physical function and general health status, while the symptomatic scores in terms of pain, fatigue, nausea and vomiting and diarrhea were significantly reduced.

Conclusion

Autologous CIK cell transfusion combined with chemotherapy can effectively enhance the immune activity of T-lymphocytes, prevent disease progression and improve the progression-free survival and QOL in patients with advanced colorectal cancer.