Dendritic cell/cytokine induced killer cell immunotherapy combined with S-1 in patients with advanced pancreatic cancer: A prospective study

Purpose: Advanced pancreatic cancer has remained challenging to treat effectively. This study aimed to investigate the clinical effects and safety of immunotherapy with dendritic cells and cytokine induced killer cells (DC-CIK) administered with the chemotherapy (CT) S-1 in this malignancy. <p>Experimental Design: Consecutive patients (n=47) with advanced pancreatic cancer were treated with either DC-CIK + S-1, DC-CIK alone, S-1 alone, or best supportive care.</p> <p>Results: DC-CIK plus S-1 produced significantly longer median OS and PFS (212 and 136 days) compared with DC-CIK (128 and 85 days), CT (141 and 92 days) or supportive care only (52 and 43 days) (P<0.001). After adjusting for competing risk factors, DC-CIK combined with S-1 and receipt of 2 or more cycles of DC-CIK treatment remained independent predictors of disease free and overall survival (P<0.05). Phenotypic analysis of peripheral blood mononuclear cells demonstrated that the CD3⁺, CD3⁺/CD4⁺ and CD8⁺/CD28⁺ T cell subsets were elevated (P <0.05), while the CD3⁺/CD8⁺, CD3⁺/CD16⁺/CD56⁺ and CD4⁺/CD25⁺ cell subsets were significantly decreased after DC-CIK cell therapy (P <0.05). There were no grade 3 or 4 toxicities. Additionally the mutational frequency in cell-free tumor DNA (cfDNA) declined in 4/14 patients who received DC-CIK, and was associated with a more favorable survival.</p> <p>Conclusion: Treatment of advanced pancreatic cancer with combined with DC-CIK infusions and S-1 was safe, resulted in favorable PFS and OS, and modulated the peripheral blood immune repertoire.

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