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Selections of appropriate regimen of high-dose chemotherapy combined with adoptive cellular therapy with dendritic and cytokine-induced killer cells improved progression-free and overall survival in patients with metastatic breast cancer: reargument of such contentious therapeutic preferences

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Abstract

Background

We hypothesized that combination of dendritic cell (DC) with autologous cytokine-induced killer (CIK) immunotherapy in setting of high-dose chemotherapy (HDC) would be effective for selected metastatic breast cancer (MBC) patients.

Patients and methods

Our previous work showed thiotepa could eradicate breast cancer stem cells. From 2004 to 2009, 79 patients received standard dose chemotherapy (SDC) of 75 mg/m2 docetaxel and 75 mg/m2 thiotepa versus 87 patients of HDC + DC/CIK: 120 mg/m2 docetaxel to mobilize peripheral CD34+ progenitor cells, a sequence of HDC (120 mg/m2 docetaxel, plus 175 mg/m2 thiotepa) + DC/CIK, with or without 400 mg/m2 carboplatin depending upon bone marrow function. The endpoints were response rates (RR), progression-free survival (PFS), and overall survival (OS).

Results

Compared with SDC, PFS and OS were improved in HDC + DC/CIK (median PFS 10.2 vs. 3.7 months, P < 0.001; median OS 33.1 vs. 15.2 months, P < 0.001). Patients of pre-menopausal, HDC as first-line treatment after metastasis, or with visceral metastasis showed prolonged PFS and OS. SDC group also achieved the similar response as previous reports.

Conclusion

Our study demonstrated the novel combination of HDC with DC/CIK to be an effective choice for the selected MBC population, in which choosing appropriate chemo regimens played important roles, and also specific HDC regimen plus DC/CIK immunotherapy showed the clinical benefits compared with chemotherapy alone.

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Acknowledgments

We are indebted to all enrolled patients to participate in this study with great cooperation and understanding. We thank Sherry Gu PhD from Duke Clinical Research Institute of Duke University, Durham, NC, USA for her assistance with the statistical analysis. This study was funded by Natural Science Foundation of China(No.81172534) and Beijing Capital Development Grant 2007-2053 Beijing. This work was partially supported by Duke-PKU Cancer Program (2007-2012).

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There is not any conflict of interest for all authors.

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Correspondence to Jun Ren or Herbert Kim Lyerly.

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Ren, J., Di, L., Song, G. et al. Selections of appropriate regimen of high-dose chemotherapy combined with adoptive cellular therapy with dendritic and cytokine-induced killer cells improved progression-free and overall survival in patients with metastatic breast cancer: reargument of such contentious therapeutic preferences. Clin Transl Oncol 15, 780–788 (2013). https://doi.org/10.1007/s12094-013-1001-9

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  • DOI: https://doi.org/10.1007/s12094-013-1001-9

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