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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


      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.


      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).


      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.


      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.