Effectiveness and safety of chemotherapy combined with cytokine-induced killer cell /dendritic cell–cytokine-induced killer cell therapy for treatment of gastric cancer in China: A systematic review and meta-analysis

• We performed a systemic evaluation of efficacy and safety of chemotherapy combined with CIK/DC-CIK on gastric cancer.
• In total, 1735 patients with gastric cancer were included and a meta-analysis was conducted.
• Seventeen trials were included in this meta-analysis.
• The combination of CIK/DC-CIK and chemotherapy was superior in prolonging the survival time, enhancing immune function, and alleviating the adverse events caused by chemotherapy.

BackgroundCurrently, cytokine-induced killer cells (CIK)/dendritic cell (DC)-CIK-mediated immunotherapy is widely used to treat gastric cancer. However, limited information regarding clinical trials on CIK/DC-CIK therapy is available. Therefore, systemic evaluation of the efficacy and safety of the combination therapy is necessary.MethodsA meta-analysis involving 1735 patients with gastric cancer was conducted. Before analysis, the study quality and heterogeneity were evaluated. The effects of chemotherapy combined with CIK/DC-CIK on gastric cancer were compared with the effects observed when chemotherapy alone was used. Pooled analysis was performed using RevMan version 5.2 from random or fixed-effect models.ResultsSeventeen trials were included. First, the analysis showed that the combination therapy significantly increased the overall survival rate and disease-free survival rate compared with those in patients treated using chemotherapy alone. The overall response rate (P = 0.002), disease control rate (P = 0.0007), and quality of life improved rate (P = 0.0008) were significantly improved in patients who received combined treatment than in patients who received chemotherapy alone. Second, the percentage of lymphocyte subsets (CD3+, CD4+ and CD3−CD56+, CD3+CD56+; P < 0.01) and the levels of interleukin-12 and interferon-γ, which reflect immune function, were significantly increased (P < 0.05) after the CIK/DC-CIK therapy. Further, carbohydrate antigen tumor markers were significantly reduced compared with the pre-therapy levels. Immunotherapy with CIK/DC-CIK obviously alleviated the adverse events caused by chemotherapy.ConclusionThe combination of CIK/DC-CIK therapy and chemotherapy was superior in prolonging the survival time, enhancing immune function and alleviating the adverse events caused by chemotherapy.