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Hideki Kimura



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    P1.04 - Immuno-oncology (ID 164)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.04-08 - Randomized Controlled Phase III Trial of Adjuvant Chemoimmunotherapy to Lung Cancer Patients: Results of Malignant Effusions (ID 130)

      09:45 - 18:00  |  Presenting Author(s): Hideki Kimura

      • Abstract

      Background

      Elucidation of cancer immunoediting from immune surveillance to immune escape and approval of immune check point inhibitors by FDA prompted immunotherapy became a forth modality next to surgery, chemotherapy and radiotherapy. We have recruited advanced lung cancer patients with poor prognosis who had undergone surgery to improve prognosis by immunotherapy.

      Method

      Objective and methods: Post-surgical lung cancer patients were randomly designated to receive either chemoimmunotherapy (4 courses of chemotherapy with 10-14 courses of cellular immunotherapy: group A) or chemotherapy (4 courses of chemotherapy: group B). Immunotherapy comprised adoptive intravenous transfer of autologous activated killer T cells and dendritic cells (AKT-DC) obtained from the regional lymph nodes of lung cancer patients. The study inclusion criteria were: <76 years; PS 0 or 1; non-small cell lung cancer; pathological stage, IB-IV. Patients whose surgery was palliative or in whom macroscopic residual tumors remained after surgery were excluded but those with microscopic residual tumors detected after a cytopathological examination were included in the study. Patients with pleural dissemination were excluded but those with malignant pleural effusion were included and received intra-thoracic chemotherapy with 20mg CDDP 4 times (group B) or chemotherapy with 4 to 8 courses of AKT-DC immunotherapy (group A) through a subcutaneous port with intrathoracic catheter installed in the thoracic cavity after resection of the primary tumors. A patient who had a recurrence of malignant ascites in group A received peritoneal infusion of AKT-DC after cell-free concentrated ascites reinfusion therapy (CART).

      Result

      A hundred-and three patients were selected for randomization. The 2-, 5-, and 7-year overall survival rates were 96.0% 69.4%, and 55.1 in group A (n=51) and 64.7%, 45.1%, and 38.1% in group B (n=52), respectively. The Hazard ratio was 0.439 in favor of group A by multivariate analysis. There were 11 group A and 9 group B patients with malignant pleural effusion. One patient in group A and 6 patients in group B had recurrence and 3 died within 2 years in group B. The difference was also significant in favor of group A. A patient with malignant ascites received 5 times AKT-DC therapy with 7 courses of CART in 2 months. Complete elimination of tumor cells accompanied with ascites eradication resulted in 9 months prolongation of survival after recurrence.

      Conclusion

      Patients with lung cancer benefited from adoptive cellular immunotherapy as an adjuvant to surgery. Intrathoracic and peritoneal cellular immunotherapy with AKT-DC are effective to patients with malignant effusions.