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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

DOI https://doi.org/10.2147/OTT.S138011

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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