Clinical efficacy and prognosis of DC-CIK cellular immunotherapy in the treatment of advanced renal cell carcinoma

OBJECTIVE Due to the low survival rate of patients with advanced renal cell carcinoma and low sensitivity to radiotherapy and chemotherapy,our group has retrospectively analyzed the clinical efficacy and safety of 72 cases of renal clear cell carcinoma combined with autologous DC-CIK cells therapy after surgery and to investigate the correlation between lymphocyte subsets and serum cholesterol.METHODS Peripheral blood mononuclear cells were collected from 72 patients with renal cell carcinoma who participated in the clinical study from the Tumor Biology Treatment Department of PLA NO.81 Hospital of from August 12,2011 to April 28,2016.These cells were induced and cultured into dendritic cells(DC)and cytokine-induced killer(CIK)cells in vitro.DCs were sensitized by lysate of renal cancer 786-0 cells and then infused into CIK cells.The clinical efficacy and safety of DC-CIK cells in treatment of renal cell carcinoma were observed.The correlation between lymphocyte subsets and serum lipid levels before and after treatment was analyzed.RESULTS After immunotherapy with DC-CIK cells in 72 patients with renal cell carcinoma,30 cases were incomplete and lost follow-up.The objective remission rate of the remaining 42 cases was 33.33%,and the disease control rate was 73.81%.The 1-year survival rate was 83%,the 2-year survival rate was 55%,and the 3-year survival rate was 40%.Triglyceride levels were elevated[(1.58±0.74)mmol/L vs(2.46±1.94)mmol/L,t=-3.216,P=0.003)]compared with those before treatment.After treatment,the proportion of CD3+CD8+cells in peripheral blood was significantly increased[(22.88±6.76)% vs(25.60±8.69)%,t=-2.760,P=0.009],the percentage of CD4+CD25+cells,CD3+CD4+cells and CD4+CD8+cells were significantly lower than those in control group[(3.51±1.23)% vs(3.05±1.27)%,t=2.318,P=0.026],[(36.00±11.34)% vs(32.80±10.88)%,t=2.828,P=0.028],[(1.76±0.88)vs(1.46±0.72),t=3.086,P=0.04].Pearson correlation analysis showed that there was a positive correlation between serum triglyceride and B cell ratio(r=0.387,P=0.011)while high density cholesterol and NK cell proportion were negatively correlated(r=0.362,P=0.018).The similar negative correlation was also found in cholesterol and regulatory T cells(r=-0.303,P=0.049).Univariate analysis showed that the TNM staging,the number of cell therapy and the KPS score before treatment were the influencing factors for the prognosis of renal cell carcinoma(all P<0.05).Multivariate analysis showed that age,TNM stage and KPS score were independent prognostic factors.CONCLUSIONS DC-CIK cellular immunotherapy is a safe and effective treatment for patients with renal cell carcinoma.Multiple treatments may improve the long-term survival rate of patients and serum cholesterol metabolism may affect tumor immunity.