The Efficacy and Safety of Dendritic Cells Co-Cultured with Cytokine-Induced Killer Cell Therapy in Combination with TACE-Predominant Minimally-Invasive Treatment for Hepatocellular Carcinoma: a Meta-Analysis

Background: To evaluate the efficacy and safety of dendritic cells (DCs) co-cultured with cytokine-induced killer cell (CIK) immunotherapy combined with transcatheter arterial chemoembolization (TACE) or TACE plus local ablation therapy for hepatocellular carcinoma (HCC).

Methods: Our meta-analysis included a comprehensive search for relevant studies published through December 12, 2014. We used Cochrane Library, PubMed, CBM, VIP, CNKI, and Wanfang data. Depending on the heterogeneity among the included studies, we calculated the pooled odds ratio (OR) and mean difference (MD) using fixed- or random-effects models. Publication biases were assessed using funnel plots and Begg's tests. Sensitivity analyses were also performed.

Results: Seven randomized controlled trials (RCTs) and one controlled clinical trial (CCT) that included 693 patients and met the inclusion criteria were analyzed. Pooled results showed that DC-CIK immunotherapy combined with TACE or TACE plus local ablation therapy significantly improved 1-year (OR = 2.00, p = 0.02) and 2-year overall survival (OR = 1.77, p = 0.04). A favored overall response rate (ORR) (OR = 1.51, p = 0.03), disease control rate (DCR) (OR = 1.81, p = 0.01), and better quality of life (OR = 3.30, p < 0.01) were observed in the DC-CIK group. Additionally, when tumor-associated T lymphocyte subsets were compared, our analyses demonstrated that the percentage of CD3+ T cells (MD(CD3+) = 21.37, p = 0.005) and the ratio of CD4+/CD8+ (MD(CD4+/CD8+) = 2.83, p = 0.02) were significantly increased in the DC-CIK therapy group.

Conclusions: The combination of DC-CIK immunotherapy and TACE or TACE plus local ablation therapy improves 1- and 2-year overall survival, ORR, DCR, and provides a better quality of life for patients with HCC.