Background & objective: Nowadays, operation is the main treatment for renal cell carcinoma (RCC). But the prognosis of advanced RCC is poor because of its high recurrence rate and resistance to conventional treatments, such as chemotherapy and radiotherapy. Hence, novel and more effective therapeutic options for advanced RCC are needed. This study was to evaluate the clinical efficacy of autologous renal tumor lysate-loaded dendritic cells (DCs) in combination with cytokine-induced killer (CIK) cells on advanced RCC.
Methods: Peripheral blood mononuclear cells were isolated from 10 patients with advanced RCC, and cultured with granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4) to produce DCs. The DCs were pulsed with autologous renal tumor cell lysate. T lymphocytes were cultured with interferon-gamma (IFN-gamma), IL-2, CD3-moAb, and IL-1alpha to prepare CIKs. After nephrectomy, the patients received intradermal DC vaccination weekly for at least 8 times, and CIKs administration biweekly for at least 4 times. Clinical and immunologic responses were evaluated by imaging examination, T lymphocytes subset changes, and delayed-type hypersensitivity (DHT) reaction, respectively.
Results: During follow-up of 6-20 months (median, 11 months), 1 case of partial remission (PR), 2 cases of stable disease (SD), and 1 case of progressive disease (PD) were identified in the 4 patients with measurable diseases; 1 case of PD was identified in the 6 patients with no measurable diseases, 1 case was lost, and no progressive disease was identified. When treated for 2 months, the levels of CD3+, CD4+, CD4+/CD8+, CD56+ were increased significantly (P<0.05) as compared with those before treatment. DTH reaction was positive in 6 patients, including the patient with PR. Except transient fever and chill, no remarkable adverse event happened during or after the treatment.
Conclusion: Autologous tumor cell lysate-pulsed DCs in combination with CIKs shows short-term efficacy on advanced RCC through inducing specific antitumor immunity, and the adverse events are tolerable.