Abstract
In this study, the safety and clinical efficacy of cryosurgery combined with allogenic NK cell immunotherapy for the treatment of advanced non-small cell lung cancer (NSCLC) were evaluated. From July 2016 to March 2017, we enrolled 60 patients who met the enrollment criteria and divided them into two groups: (1) the simple cryoablation group (n = 30) and (2) the cryoablation combined with allogenic NK cell group (n = 30). The changes in immune function, quality of life, and clinical response were evaluated. We found that allogenic NK cells combined with cryosurgical treatment for advanced NSCLC have a synergistic effect, which not only enhancing the immune function of patients, improving the quality of life, and significantly increasing the response rate (RR) and disease control rate (DCR) compared to cryoablation group. This study is the first clinical trial of allogenic NK cells combined with cryosurgery for the treatment of advanced NSCLC and preliminaily its safety and efficacy.
Similar content being viewed by others
References
Jemal A, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.
Chen Z, et al. Non-small-cell lung cancers: a heterogeneous set of diseases. Nat Rev Cancer. 2014;14:535–46.
Yang L, et al. Enhanced antitumor effects of DC-activated CIKs to chemotherapy treatment in a single cohort of advanced non-small-cell lung cancer patients. Cancer Immunol Immunother. 2013;62:65–73.
Zhao M, et al. Effects of a gemcitabine plus platinum regimen combined with a dendritic cell-cytokine induced killer immunotherapy on recurrence and survival rate of non-small cell lung cancer patients. Exp Ther Med. 2014;7:1403–7.
Pisters KM. Adjuvant chemotherapy for non-small-cell lung cancer--the smoke clears. N Engl J Med. 2005;352:2640–2.
Keller SM, et al. A randomized trial of postoperative adjuvant therapy in patients with completely resected stage II or IIIA non-small-cell lung cancer. Eastern cooperative oncology group. N Engl J Med. 2000;343:1217–22.
Felip E, et al. Adjuvant treatment of resected nonsmall cell lung cancer: state of the art and new potential developments. Curr Opin Oncol. 2013;25:115–20.
Sharma A, et al. How I do it: radiofrequency ablation and cryoablation of lung tumors. J Thorac Imaging. 2011;26:162–74.
Maiwand MO, et al. The application of cryosurgery in the treatment of lung cancer. Cryobiology. 2004;48:55–61.
Kornprat P, et al. Role of intraoperative thermoablation combined with resection in the treatment of hepatic metastasis from colorectal cancer. Arch Surg. 2007;142:1087–92.
Levy D, et al. Current state of urological cryosurgery: prostate and kidney. BJU Int. 2010;105:590–600.
Izumi Y, et al. The acute effects of transthoracic cryoablation on normal lung evaluated in a porcine model. Ann Thorac Surg. 2005;79:318–22. discussion 22
Niu L, et al. Cryosurgery for lung cancer. J Thorac Dis. 2012;4:408–19.
Xu KC, et al. Percutaneous cryoablation in combination with ethanol injection for unresectable hepatocellular carcinoma. World J Gastroenterol. 2003;9:2686–9.
Orlacchio A, et al. Percutaneous cryoablation of small hepatocellular carcinoma with US guidance and CT monitoring: initial experience. Cardiovasc Intervent Radiol. 2008;31:587–94.
Aerts JG, et al. Tumor-specific cytotoxic T cells are crucial for efficacy of immunomodulatory antibodies in patients with lung cancer. Cancer Res. 2013;73:2381–8.
Lv M, et al. miR141-CXCL1-CXCR2 signaling-induced Treg recruitment regulates metastases and survival of non-small cell lung cancer. Mol Cancer Ther. 2014;13:3152–62.
Topalian SL, et al. Safety, activity, and immune correlates of anti-PD-1 antibody in cancer. N Engl J Med. 2012;366:2443–54.
Thomas A, et al. Immunotherapies for non-small-cell lung cancer and mesothelioma. Lancet Oncol. 2012;13:e301–10.
Hasegawa T, et al. Prognostic value of peripheral and local forkhead box P3+ regulatory T cells in patients with non-small-cell lung cancer. Mol Clin Oncol. 2014;2:685–94.
Hanahan D, et al. Hallmarks of cancer: the next generation. Cell. 2011;144:646–74.
Drake CG, et al. Mechanisms of immune evasion by tumors. Adv Immunol. 2006;90:51–81.
Zhao Y, et al. Enhanced NK cell adoptive antitumor effects against breast cancer in vitro via blockade of the transforming growth factor-beta signaling pathway. Onco Targets Ther. 2015;8:1553–9.
Cheng M, et al. NK cell-based immunotherapy for malignant diseases. Cell Mol Immunol. 2013;10:230–52.
Wang D, et al. Clinical research of genetically modified dendritic cells in combination with cytokine-induced killer cell treatment in advanced renal cancer. BMC Cancer. 2014;14:251.
Li JJ, et al. Autologous cytokine-induced killer cell transfusion in combination with gemcitabine plus cisplatin regimen chemotherapy for metastatic nasopharyngeal carcinoma. J Immunother. 2012;35:189–95.
Pan K, et al. Clinical activity of adjuvant cytokine-induced killer cell immunotherapy in patients with post-mastectomy triple-negative breast cancer. Clin Cancer Res. 2014;20:3003–11.
Pan K, et al. The efficacy of cytokine-induced killer cell infusion as an adjuvant therapy for postoperative hepatocellular carcinoma patients. Ann Surg Oncol. 2013;20:4305–11.
Ljunggren HG, et al. Prospects for the use of NK cells in immunotherapy of human cancer. Nat Rev Immunol. 2007;7:329–39.
Roberti MP, et al. Biological role of NK cells and immunotherapeutic approaches in breast cancer. Front Immunol. 2012;3:375.
Niu L, et al. Combination of cryosurgery and iodine-125 seeds brachytherapy for lung cancer. J Thorac Dis. 2012;4:504–7.
Zhang M, et al. Anti-West Nile virus activity of in vitro expanded human primary natural killer cells. BMC Immunol. 2010;11:3.
Witt CS, et al. The relevance of natural killer cell human leucocyte antigen epitopes and killer cell immunoglobulin-like receptors in bone marrow transplantation. Vox Sang. 2006;90:10–20.
Forte P, et al. HLA-Cw4 expression on porcine endothelial cells reduces cytotoxicity and adhesion mediated by CD158a+ human NK cells. Xenotransplantation. 2009;16:19–26.
Kunert K, et al. KIR/HLA ligand incompatibility in kidney transplantation. Transplantation. 2007;84:1527–33.
Moretta L, et al. Killer immunoglobulin-like receptors. Curr Opin Immunol. 2004;16:626–33.
Imai C, et al. Genetic modification of primary natural killer cells overcomes inhibitory signals and induces specific killing of leukemic cells. Blood. 2005;106:376–83.
Miller AB, et al. Reporting results of cancer treatment. Cancer. 1981;47:207–14.
Goldberg SN, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol. 2005;16:765–78.
Eisenhauer EA, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.
Goldberg SN, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology. 2005;235:728–39.
Asimakopoulos G, et al. Cryosurgery for malignant endobronchial tumors: analysis of outcome. Chest. 2005;127:2007–14.
Yamauchi Y, et al. Percutaneous cryoablation for pulmonary nodules in the residual lung after pneumonectomy: report of two cases. Chest. 2011;140:1633–7.
Ljunggren HG, et al. In search of the ‘missing self’: MHC molecules and NK cell recognition. Immunol Today. 1990;11:237–44.
Mikelsaar AV, et al. Epitope of titin A-band-specific monoclonal antibody Tit1 5 H1.1 is highly conserved in several Fn3 domains of the titin molecule. Centriole staining in human, mouse and zebrafish cells. Cell Div. 2012;7:21.
Burns LJ, et al. IL-2-based immunotherapy after autologous transplantation for lymphoma and breast cancer induces immune activation and cytokine release: a phase I/II trial. Bone Marrow Transplant. 2003;32:177–86.
de Magalhaes-Silverman M, et al. Posttransplant adoptive immunotherapy with activated natural killer cells in patients with metastatic breast cancer. J Immunother. 2000;23:154–60.
Iliopoulou EG, et al. A phase I trial of adoptive transfer of allogeneic natural killer cells in patients with advanced non-small cell lung cancer. Cancer Immunol Immunother. 2010;59:1781–9.
Re F, et al. Killer cell Ig-like receptors ligand-mismatched, alloreactive natural killer cells lyse primary solid tumors. Cancer. 2006;107:640–8.
Geller MA, et al. A phase II study of allogeneic natural killer cell therapy to treat patients with recurrent ovarian and breast cancer. Cytotherapy. 2011;13:98–107.
Acknowledgements
We would like to thank the native English speaking scientists of Elixigen Company for editing our manuscript. This work was supported by the International Scientific Fund of Fuda Cancer Hospital, Guangzhou, China [Y2016-ZD-004].
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
This clinical trial was registered at the US National Institutes of Health (ID: NCT02843815; Ph1/Ph2) and was approved by the Ethics Committee of Guangzhou Fuda Cancer Hospital. In accordance with the Declaration of Helsinki, written informed consent was obtained from each participant at the Fuda Cancer Hospital
Conflicts of interest
The authors declare that they have no conflict of interests.
Rights and permissions
About this article
Cite this article
Lin, M., Liang, SZ., Wang, XH. et al. Clinical efficacy of percutaneous cryoablation combined with allogenic NK cell immunotherapy for advanced non-small cell lung cancer. Immunol Res 65, 880–887 (2017). https://doi.org/10.1007/s12026-017-8927-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12026-017-8927-x