The Efficacy And Safety Of Adoptive Cell Therapy Combined With Chemotherapy For Advanced Gastric Adenocarcinoma

Objective:To observe the clinical efficacy and safety of adoptive cell therapy(ACT)combined with chemotherapy in advanced gastric adenocarcinoma.Methods:The peripheral blood mononuclear cells of 32 patients with advanced gastric adenocarcinoma who were hospitalized in the Department of Medical Oncology,Cancer Hospital,Chinese Academy of Medical Sciences during November 2014 to October 2017,were collected to obtain DC and CIK cells via in vitro culture,then transfused this cells into patients.All patients were simultaneously treated with chemotherapy(SOX or SP)regimen.Observe the clinical efficacy,adverse reactions and changes of T lymphocyte subsets in peripheral blood before and after treatment.Results:32 patients with advanced gastric cancer were treated with DC-CIK combined with chemotherapy.The median overall survival time(mOS)was 15.7 months,and the median progression-free survival(mPFS)was 5.1 months.The 6-month and 12-month survival rates were 90.6%and 61.9%,respectively.Among them,the objective response rate(ORR)of 24 patients with measurable lesions was 41.7%,and the disease control rate(DCR)was 91.7%.The post-treatment percentage of CD3+CD56-,CD3+CD4+,CD3+CD56+,CD3-CD56+,CD3+CD45RO+cells in peripheral blood increased,while the percentage of CD3+CD8+cells decreased,but there was no significant statistical difference.Compared with pre-treatment,the absolute count of T-lymphocyte subsets in peripheral blood significantly increased,like lymphocytes(1546.1 ± 491.17vs 1231.7 ±412.47/ul,p<0.001),CD3+CD56-cells(1085.5 ± 392.89 vs 832.15±278.81 cells/ul,P<0.001),CD3+CD4+cells(682.2± 232.52vs 517.3± 171.41 cells/ul,P<0.001),CD3+CD56+cells(96.53 ± 98.84 vs 74.91 ± 84.11 cells/ul,P=0.006),CD3-CD56+cells(435.28 ± 574.26 vs 284.98± 317.13 cells/ul,P=0.024),CD3+CD8+cells(347.8±190.58 vs 283.28 ± 144.83 cells/ul,P less than 0.001),CD3+CD45RO+cells(656.74 ±285 vs 498.97 ± 230.43/ul,P=0.001),the difference was statistically significant.All patients had no obvious adverse reactions related to immunotherapy,and no patients withdrew from the trial due to intolerable adverse reactions.Conclusion:The treatment of DC-CIK cells combined with chemotherapy can obviously optimize the immune function of advanced GC patients,is a safe and effective treatment and worth further randomized controlled study.