Prognostic Factors for Pancreatic Cancer Patients Treated with Immune-cell Therapy

Anticancer Res. 2018 Jul;38(7):4353-4360. doi: 10.21873/anticanres.12736.

Abstract

Background/aim: The past 17 years, immune-cell therapy has been administered to 990 patients with advanced or recurrent pancreatic adenocarcinoma and 50 patients with curatively resected pancreatic adenocarcinoma.

Materials and methods: The correlation between overall survival (OS) and various factors including sex, age, performance status (PS), distant metastasis, chemotherapy, radiotherapy, and type of immune-cell therapy were evaluated by univariate and multivariate analyses.

Results: The median OS of advanced or recurrent pancreatic cancer was 5.8 months, and the prognosis was improved in pancreatic cancer patients who received immune-cell therapy with PS scores of 0-1 [hazard risk (HR)=0.56; 95% confidence interval (CI)=0.46-0.68; p<0.0001], chemotherapy (HR=0.68; 95%CI=0.54-0.87; p=0.002), or radiotherapy (HR=0.76; 95%CI=0.63-0.93; p=0.006). Multivariate analysis demonstrated that distant metastasis indicated a poor prognosis for pancreatic cancer patients that were administered immune-cell therapy (HR=1.62; 95%CI=1.37-1.93; p<0.0001). Additionally, the combined immune-cell therapy with αβ T cell and dendritic cell (DC) vaccine provided a survival benefit in advanced or recurrent pancreatic cancer patients (HR=0.69; 95%CI=0.57-0.83; p<0.0001).

Conclusion: A survival benefit could be potentially obtained with better PS by the combination of αβ T cell therapy, DC vaccine therapy, and chemotherapy at an early stage in pancreatic cancer.

Keywords: Immune-cell therapy; dendritic cell vaccine; pancreatic cancer; prognostic factors; αβ T cell therapy.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cancer Vaccines / therapeutic use*
  • Dendritic Cells / transplantation
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / therapy*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • T-Lymphocytes / transplantation
  • Treatment Outcome

Substances

  • Cancer Vaccines