FOLFOX regimen plus dendritic cells–cytokine-induced killer cells immunotherapy for the treatment of colorectal cancer: a meta-analysis
Authors Liu Y, Zheng Z, Zhang QX, Zhou XL, Feng YK, Yan AQ
Received 26 March 2017
Accepted for publication 19 April 2017
Published 18 May 2017 Volume 2017:10 Pages 2621—2633
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Yao Dai
Yan Liu,1 Zhong Zheng,1 Qixin Zhang,2 Xinling Zhou,3 Yikuan Feng,1 Anquan Yan2
1Department of Gastroenterology, 2Department of Health Care, 3Digestive Endoscopy Center, Weifang People’s Hospital, Weifang, China
Purpose: To systematically investigate the efficacy and safety of the combination of FOLFOX (oxaliplatin, 5-fluorouracil, and leucovorin) regimen and cocultured dendritic cells and cytokine-induced killer cells (DC-CIK) immunotherapy for the treatment of colorectal cancer (CRC).
Methods: Publications reporting the clinical trials’ responses or safety of FOLFOX regimen combined with DC-CIK immunotherapy in treating CRC patients were searched in PubMed, Embase, Cochrane Library, China National Knowledge Internet, and Wanfang databases. Trials meeting the selection criteria were analyzed. The overall survival (OS), overall response rate (ORR), disease control rate (DCR), tumor markers, immune function, and adverse events were evaluated.
Results: Ten trials including 881 CRC patients were analyzed in this meta-analysis. The combined therapy showed advantages over FOLFOX treatment-alone in 2-year OS (odds ratio [OR] =2.77, confidence interval [CI] =1.58–4.86, P=0.0004), ORR (OR =1.85, CI =1.34–2.56, P=0.0002), and DCR (OR =2.54, CI =1.76–3.67, P<0.00001), with statistical significance. After immunotherapy, lymphocyte subset percentages of CD3+ (P=0.0006) and CD4+ (P=0.01), CD4+/CD8+ ratio (P=0.0003), and levels of cytokines IFN-γ (P=0.003) and IL-2 (P=0.01) were significantly increased, whereas analysis of CD8+, CD3-CD56+, CD3+CD56+, CD4+CD25+, IL-6, and TNF-α did not show any significant difference (P>0.05). Moreover, the level of carcinoembryonic antigen was also decreased significantly upon immunotherapy (P<0.00001).
Conclusion: The combination of FOLFOX regimen and DC-CIK immunotherapy was safe and effective for CRC patients.
Keywords: FOLFOX, dendritic cells, cytokine-induced killer cells, colorectal cancer, meta-analysis
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