Cytokine-induced killer (CIK) cell therapy for patients with hepatocellular carcinoma: efficacy and safety

Randomized phase II and III trials on CIK cell-based therapy were identified by electronic searches using a combination of "hepatocellular carcinoma" and "cytokine-induced killer cells".The analysis showed significant survival benefit (one-year survival, p < 0.001; two-year survival, p < 0.001; median overall survival, p < 0.001) in favor of CIK-based therapy. Comparison of CIK group versus non-CIK group resulted in a significantly prolonged progression-free survival (PFS) (p < 0.01). A favored disease control rate (DCR) and overall response rate (ORR) were also observed in patients receiving CIK cell therapy (p < 0.01). Meanwhile, patients in the CIK group showed better quality of life (QoL), diminished HBV-DNA content and AFP level (p < 0.01). Comparing T-lymphocyte subsets in peripheral blood, the analysis showed the ratio of CD3+, CD4+, CD4+CD8+ and CD3+CD4+ T cells significantly increased in the CIK group, compared with the non-CIK group (p < 0.01).CIK cell therapy demonstrated a significant superiority in prolonging the median overall survival, PFS, DCR, ORR and QoL of HCC patients. These results support further larger scale randomized controlled trials for HCC patients with or without the combination of other therapeutic methods.Hepatocellular carcinoma (HCC) is the third most common cancer globally, with a poor prognosis and limited systemic treatment options [1]. In men, it is the fifth most common cancer worldwide and the third-leading cause of cancer-related death [2]. HCC is resistant to conventional chemotherapy and is insensitive to radiotherapy. Surgery, transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) are considered as the main treatments for HCC today [3]. However, the recurrence rate is still high, and long-term survival is unsatisfactory, as approximately 80% of patients die within a year of diagnosis. After curative resection or transplantation, tumor recurrence rate can be as high as 25% per year. Although some c