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一项关于自体细胞因子诱导的杀伤细胞联合程序性细胞死亡受体-1 单克隆抗体西妥昔单抗加化疗治疗晚期非小细胞肺癌患者的 Ib 期临床试验。

A Phase IB Trial of Autologous Cytokine-Induced Killer Cells in Combination with Sintilimab, Monoclonal Antibody Against Programmed Cell Death-1, plus Chemotherapy in Patients with Advanced Non-Small-Cell Lung Cancer.

机构信息

Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China; Key Laboratory of Cancer Immunology and Biotherapy, Tianjin 300060, China.

Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China; Key Laboratory of Cancer Immunology and Biotherapy, Tianjin 300060, China.

出版信息

Clin Lung Cancer. 2022 Dec;23(8):709-719. doi: 10.1016/j.cllc.2022.07.009. Epub 2022 Jul 21.

Abstract

INTRODUCTION

Can the Cytokine-induced killer (CIK) cells in combination with immune checkpoint inhibitor further improve the efficacy of chemotherapy in non-small cell lung cancer (NSCLC) patients? What are the adverse reactions of this combination therapy? But these problems are not clear. Therefore, we conducted a phase 1b trial to evaluate the safety and efficacy of autologous CIK cells therapy combined with Sintilimab, antibody against programmed cell death-1, plus chemotherapy in untreated, advanced NSCLC patients.

PATIENTS AND METHODS

Patients with stage IIIB/IIIC/IV NSCLC received Sintilimab, platinum-based doublet chemotherapy, and CIK cells every 3 weeks for 4 cycles, then maintenance treatment with Sintilimab in squamous and with Sintilimab plus pemetrexed in non-squamous NSCLC until disease progression or unacceptable toxicity or 2 years. The primary endpoints were safety and objective response rate (ORR).

RESULTS

Thirty-four patients received the treatment. 94.1% of patients experienced treatment-related adverse events (TRAEs). Grade 3 or greater TRAEs occurred in 64.7% of patients. One (2.9%) patient died of grade 5 immune-related pneumonia. The ORR and DCR were 82.4% (95% CI, 65.5%-93.2%) and 100.0% (95% CI, 89.7%-100.0%), respectively. Objective responses were evaluated in 14 of 15 non-squamous patients (93.3%; 95% CI, 68.1%-99.8%) and in 14 of 19 squamous patients (73.7%; 95% CI, 48.8%-90.9%). Median PFS was 19.3 months (95% CI, 8.3 months to not available).

CONCLUSION

Autologous CIK cells immunotherapy in combination with Sintilimab plus chemotherapy was well tolerable and showed encouraging efficacy in patients with previously untreated, advanced NSCLC (ClinicalTrials.gov number, NCT03987867).

摘要

介绍

细胞因子诱导的杀伤(CIK)细胞联合免疫检查点抑制剂能否进一步提高非小细胞肺癌(NSCLC)患者化疗的疗效?这种联合治疗的不良反应有哪些?但这些问题尚不清楚。因此,我们进行了一项 1b 期试验,以评估自体 CIK 细胞治疗联合程序性细胞死亡蛋白-1 抗体 Sintilimab 加化疗治疗未经治疗的晚期 NSCLC 患者的安全性和疗效。

患者和方法

IIIb/IIIC/IV 期 NSCLC 患者每 3 周接受 Sintilimab、铂类双联化疗和 CIK 细胞治疗 4 个周期,然后在鳞状 NSCLC 中用 Sintilimab 维持治疗,在非鳞状 NSCLC 中用 Sintilimab 加培美曲塞维持治疗,直至疾病进展或不可接受的毒性或 2 年。主要终点是安全性和客观缓解率(ORR)。

结果

34 例患者接受了治疗。94.1%的患者出现治疗相关不良事件(TRAEs)。64.7%的患者发生 3 级或更高级别的 TRAEs。1 例(2.9%)患者死于 5 级免疫相关肺炎。ORR 和 DCR 分别为 82.4%(95%CI,65.5%-93.2%)和 100.0%(95%CI,89.7%-100.0%)。15 例非鳞状患者中的 14 例(93.3%;95%CI,68.1%-99.8%)和 19 例鳞状患者中的 14 例(73.7%;95%CI,48.8%-90.9%)评估了客观缓解。中位 PFS 为 19.3 个月(95%CI,8.3 个月至无法评估)。

结论

自体 CIK 细胞免疫疗法联合 Sintilimab 加化疗在未经治疗的晚期 NSCLC 患者中耐受性良好,疗效令人鼓舞(ClinicalTrials.gov 编号:NCT03987867)。

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