粒巨细胞集落刺激因子联合异体肿瘤细胞疫苗治疗晚期实体瘤的疗效观察  

Effect of granulocyte macrophage colony-stimulating factor combined with allogeneic cellular immunotherapy for advanced cancer

作　　者：康红刚[1] 王运良[1] 于津浦[1] 曹水[1] 任宝柱[1] 张新伟[1] 张维红[1] 韩颖[1] 任秀宝[1] 

机构地区：[1]天津医科大学肿瘤医院生物治疗科,天津市肿瘤防治重点实验室,天津300060

出　　处：《天津医科大学学报》2009年第3期362-365,375,共5页Journal of Tianjin Medical University

基　　金：天津市科技创新专项资金资助(06FZZDSF01500)

摘　　要：目的:探讨粒巨细胞集落刺激因子(GM-CSF)联合异体肿瘤细胞疫苗的安全性和有效性。方法:收录病理明确的IV期癌症患者60例,其中恶性黑色素瘤11例,卵巢癌10例,肾癌15例,胃/结直肠癌14例,乳腺癌10例。每周皮下注射肿瘤细胞和GM-CSF分泌细胞混合物1ml;共6次。在第1,5次注射同时,进行DTH接种试验。治疗前后取外周血样进行淋巴细胞亚型及细胞因子检测。治疗完成1个月后进行影像学检查。结果:所有病人对治疗耐受良好,无脱组患者。主要不良反应为,注射局部红肿疼痛,硬结,瘙痒和发热。4例治疗后有影像学好转但未达到部分缓解,40例稳定,16例进展。DTH阳性率68%(41/60)。流式细胞仪检测治疗后CD8+T细胞(CTL)明显增加(P<0.05),CD4+CD25+CD127-T细胞(Treg)降低(P<0.05)。ELISA检测IFN-γ治疗前后的变化无统计学意义,但有升高趋势。结论:异体GM-CSF联合肿瘤细胞疫苗治疗安全,耐受良好,能改善患者的机体免疫状态。Objective： To evaluate the feasibility, toxicity,immunologic,and clinical activity of tumor- Vaccination. Methods： Stage Ⅳ 60 patients by pathology were collected, including melanoma （n=11）, ovary cancer （n=10）, renal cell carcinoma （n=15）, gastric/colorectal carcinoma （n=14）, breast cancer （n-10）. Vaccinations were subcutaneouly injected weekly for 6 weeks. At the first and fifth vaccine injections, DTH were injected. Lyphoma subtype and cytokine of the peripheral blood were tested at pre-, pro-treatment. Results： All the patients completed the treatment. Toxicities included local injection-site reactions, and fever. Four had mixed responses （MR）, forty had stable disease （SD）, sixteen had progressed disease（PD）, forty-one cases had DTH positive 68% （41/60）. All patients had CDS＋T cell （CTL） significantly increased （P〈0.05）, CD4^＋CD25^＋ CD 127-T cell （Treg） significantly decreased （P〈0.05）. All the patients had IFN-γ increase tendency. Conclusion： This allogeneic cancer immunotherapy has a favorable safety profiles and immunologically active.

关 键 词：肿瘤细胞疫苗 晚期癌症 GM—CSF 

分 类 号：R730.54[医药卫生—肿瘤]