Published online Aug 7, 2017. doi: 10.3748/wjg.v23.i29.5395
Peer-review started: January 16, 2016
First decision: February 9, 2017
Revised: February 25, 2017
Accepted: March 4, 2017
Article in press: March 6, 2017
Published online: August 7, 2017
To assess the efficacy and safety of a new treatment modality, cellular immune therapy based on personalized peptide vaccination (PPV-DC-CTL) combined with radiotherapy, for treating advanced hepatocellular carcinoma (HCC).
A total of nine patients with advanced HCC were enrolled. Multidisciplinary consultation confirmed that all the patients definitely had no opportunity of surgery, because four patients had multiple liver metastases (the number of liver lesions > 3), one patient had liver metastases and portal vein tumor thrombosis, one patient had lung and bone metastases, two patients had liver and lung metastases and one patient had liver metastasis and peritoneal metastasis. Patients with metastasis were treated with precise radiotherapy combined with PPV-DC-CTL.
Following radiotherapy and one to three cycles of PPV-DC-CTL treatment, AFP levels were significantly decreased in six patients and imaging assessment of the lesions showed a partial response (PR) in three patients and stable disease in the other three patients. The response rate was 33% and disease control rate was 66%. This regimen was found to be safe and well tolerated. None of the patients developed liver or kidney side effects. Only one patient developed grade II bone marrow suppression and the remaining patients had no significant hematological side effects.
Radiotherapy combined with PPV-DC-CTL provides a new therapeutic strategy for patients with advanced HCC, which is well tolerated, safe, feasible and effective.
Core tip: Advanced hepatocellular carcinoma (HCC) is a challenging disease to treat because of its advanced stage at diagnosis and rapid progression. We developed a new treatment modality, cellular immune therapy based on personalized peptide vaccination combined with radiotherapy, to treat advanced HCC. It integrates personalized peptide vaccination in tumor immunotherapy, takes full advantages of the immune modulation of radiotherapy, promotes tumor cells to release antigens and results in a more effective therapeutic strategy with regard to local and systemic control.