Efficacy and safety of dendritic cells co-cultured with cytokine-induced killer cells immunotherapy for non-small-cell lung cancer

• The PFS, OS, and DCR were improved in NSCLC patients received DC-CIK immunotherapy.
• DC-CIK immunotherapy didn't induce more frequent and serious adverse events.
• DC-CIK immunotherapy is an effective and safe therapeutic approach for NSCLC.

Dendritic cells co-cultured with cytokine-induced killer cells (DC-CIK) immunotherapy has been widely studied and might be a new therapeutic strategy for non-small-cell lung cancer (NSCLC). We aimed to comprehensively and quantitatively evaluate the efficacy and safety of DC-CIK immunotherapy in NSCLC. Pubmed, Embase, Cochrane Library, and Web of Science were searched for randomized controlled trials comparing DC-CIK immunotherapy with control therapies in NSCLC. A total of 505 patients from 6 trials were enrolled. Compared with control therapies, DC-CIK immunotherapy significantly improved progression-free survival (PFS) [hazard ratio (HR): 0.528, 95% confidence interval (CI): 0.390–0.715, P < 0.001], overall survival (OS) (HR: 0.619, 95% CI: 0.487–0.786, P < 0.001), and disease control rates (DCR) [relative risk (RR): 1.250, 95% CI: 1.058–1.477, P = 0.009], but objective response rates (ORR) (RR: 1.190, 95% CI: 0.561–2.526, P = 0.650) was not improved for DC-CIK immunotherapy. The risks of all-grade anemia, leukopenia, dermatosis, diarrhea, nausea, acratia, and chest distress in patients receiving DC-CIK immunotherapy were comparable to those receiving control therapies. This meta-analysis demonstrates DC-CIK immunotherapy has superiority in PFS, OS, and DCR for NSCLC patients, and no more serious adverse events appeared. Further studies to provide solid evidence for the routine clinical use of DC-CIK immunotherapy are urgently needed.