Cong Chen1, Yin-Hua Ma2, Ya-Ting Zhang1, Fan Zhang1, Ning Zhou3, Xiang Wang1, Tao Liu4, Yu-Min Li5. 1. Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China; The Second Clinical Medical College of Lanzhou University, Lanzhou 730030, Gansu, China. 2. Department of Hematology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, Shaanxi, China. 3. The Second Clinical Medical College of Lanzhou University, Lanzhou 730030, Gansu, China; The First People's Hospital of Lanzhou City, Lanzhou 730050, Gansu, China. 4. The Second Clinical Medical College of Lanzhou University, Lanzhou 730030, Gansu, China; Key Laboratory of Digestive System Tumors of Gansu Province, Lanzhou 730030, Gansu, China; Biotechnology Translational Medical Center of Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. 5. Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China; The Second Clinical Medical College of Lanzhou University, Lanzhou 730030, Gansu, China; Key Laboratory of Digestive System Tumors of Gansu Province, Lanzhou 730030, Gansu, China; Biotechnology Translational Medical Center of Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. Electronic address: liym@lzu.edu.cn.
Abstract
BACKGROUND AIMS: Dendritic cell (DC)-based immunotherapy has recently been reported frequently in the treatment of hepatocellular carcinoma (HCC); however, its efficacy remains controversial. In this study, we aimed to evaluate the clinical efficacy of DC-based immunotherapy on HCC by conducting a systematic review and meta-analysis. METHODS: PubMed, Cochrane Library, Embase and Web of Science were searched to identify clinical trials on DC-based immunotherapy for HCC published up to January 31, 2018. The articles were selected according to pre-established inclusion criteria and methodologic quality, and publication bias were evaluated. RESULTS: A total of 1276 cases from 19 clinical trials were included. Compared with traditional treatment, further DC-based therapy enhanced the CD4+ T/CD8+ T ratio (standardized mean difference: 0.68, 95% confidence interval [CI] 0.46-0.89, P < 0.001); increased the 1-year, 18-month and 5-year progression-free survival (PFS) rate and the 1-year, 18-month and 2-year overall survival (OS) rate (relative risk > 1, P < 0.05), prolonged the median PFS time (median survival ratio [MSR]: 1.98, 95% CI: 1.60-2.46, P < 0.001) and median OS time (MSR: 1.72, 95% CI: 1.51-1.96, P < 0.001). Adverse reactions were mild. CONCLUSIONS: DC-based therapy not only enhanced anti-tumor immunity, improved the survival rate and prolonged the survival time of HCC patients, but it was also safe. These findings will provide encouraging information for further development of DC-based immunotherapy as an adjuvant treatment for HCC. However, the results must be interpreted with caution because of the small study numbers, publication bias and the various of study designs, pre-treatment and therapeutic processes of DCs.
BACKGROUND AIMS: Dendritic cell (DC)-based immunotherapy has recently been reported frequently in the treatment of hepatocellular carcinoma (HCC); however, its efficacy remains controversial. In this study, we aimed to evaluate the clinical efficacy of DC-based immunotherapy on HCC by conducting a systematic review and meta-analysis. METHODS: PubMed, Cochrane Library, Embase and Web of Science were searched to identify clinical trials on DC-based immunotherapy for HCC published up to January 31, 2018. The articles were selected according to pre-established inclusion criteria and methodologic quality, and publication bias were evaluated. RESULTS: A total of 1276 cases from 19 clinical trials were included. Compared with traditional treatment, further DC-based therapy enhanced the CD4+ T/CD8+ T ratio (standardized mean difference: 0.68, 95% confidence interval [CI] 0.46-0.89, P < 0.001); increased the 1-year, 18-month and 5-year progression-free survival (PFS) rate and the 1-year, 18-month and 2-year overall survival (OS) rate (relative risk > 1, P < 0.05), prolonged the median PFS time (median survival ratio [MSR]: 1.98, 95% CI: 1.60-2.46, P < 0.001) and median OS time (MSR: 1.72, 95% CI: 1.51-1.96, P < 0.001). Adverse reactions were mild. CONCLUSIONS: DC-based therapy not only enhanced anti-tumor immunity, improved the survival rate and prolonged the survival time of HCC patients, but it was also safe. These findings will provide encouraging information for further development of DC-based immunotherapy as an adjuvant treatment for HCC. However, the results must be interpreted with caution because of the small study numbers, publication bias and the various of study designs, pre-treatment and therapeutic processes of DCs.