Chemotherapy combined with dendritic cell vaccine and cytokine-induced killer cells in the treatment of colorectal carcinoma: a meta-analysis

Figures & data

Figure 1 Flow diagram of the article search, screening, and study inclusion process.

Abbreviations: CIK, cytokine-induced killer; DC, dendritic cell.

Table 1 Clinical information on the patients in the four eligible trials

Study	Tumor stage	All patients (male patients)	CIK regimen	DC regimen	CIK cell culture conditions	DC culture conditions
Gao et al^Citation8	I–IV	26 (U)	5.9±2.2×10^9	1.9±7.9×10^7	IL-2, IFN-γ, CD3	Tumor lysate IL-4, GM-CSF
Lin et al^Citation17	IV	255 (140)	1.0×10^9	1.0×10^7	IL-2, IFN-γ, CD3	Tumor lysate IL-4, GM-CSF TNF
Niu et al^Citation25	I–IV	239 (113)	1.0×10^9	1.0×10^7	IL-2, IFN-γ, CD3	Tumor lysate IL-4, GM-CSF TNF
Zhu et al^Citation54	IV	351 (229)	1.0×10^9	1.0×10^7	IL-2, IFN-γ, CD3	Tumor lysate IL-4, GM-CSF TNF
Study	0.5-year OS (%) of DC-CIK/chemo (chemo)	1-year OS (%) of DC-CIK/chemo (chemo)	1.5-year OS (%) of DC-CIK/chemo (chemo)	2-year OS (%) of DC-CIK/chemo (chemo)	0.5-year DFS (%) of DC-CIK/chemo (chemo)	1-year DFS (%) of DC-CIK/chemo (chemo)
Gao et al^Citation8	100 (84.6)	100 (76.9)	100 (53.8)	92.3 (41.2)	100 (76.9)	100 (69.2)
Lin et al^Citation17	100 (90.1)	74.6 (34.7)	24.6 (9.1)	22.4(7.4)	—	—
Niu et al^Citation25	76.5 (45.5)	47.1 (18.2)	—	—	52.7 (34.6)	21.6 (9.2)
Zhu et al^Citation54	90 (83.7)	81 (69.7)	72 (57.8)	—	—	—

Abbreviations: CIK, cytokine-induced killer; DC, dendritic cell; U, unknown; GM-CSF, granulocyte macrophage colony-stimulating factor; TNF, tumor necrosis factor; OS, overall survival; DC-CIK/chemo, DC vaccine and CIK cell immunotherapy combined with chemotherapy; Chemo, chemotherapy alone; DFS, disease-free survival.

Figure 2 Forest plot of the comparison of OS (random effects).

Note: A random-effects meta-analysis model (M-H method) was used for evaluation.

Abbreviations: DC-CIK/chemo, DC-CIK immunotherapy combined with chemotherapy; Chemo, chemotherapy alone; OS, overall survival.

Figure 3 Forest plot of the comparison of OS (fixed effects).

Note: A fixed effects meta-analysis model (M-H method) was used for evaluation.

Abbreviations: DC-CIK/chemo, DC-CIK immunotherapy combined with chemotherapy; Chemo, chemotherapy alone; OS, overall survival.

Figure 4 Mean survival curve for the combination therapy (DC-CIK/chemo) and control (chemo) groups.

Notes: A paired t-test was used for statistical analysis (P=0.025; P-values less than 0.05 were considered significant).

Abbreviations: DC-CIK/chemo, DC-CIK immunotherapy combined with chemotherapy; chemo, chemotherapy alone; OS, overall survival.

Figure 5 Forest plot of the comparison of DFS (random effects).

Note: A random-effect meta-analysis model (M-H method) was used for evaluation.

Abbreviations: DC-CIK/chemo, DC-CIK immunotherapy combined with chemotherapy; Chemo, chemotherapy alone; DFS, disease-free survival.

Figure 6 Forest plot of the comparison of DFS (fixed effects).

Note: A fixed effects meta-analysis model (M-H method) was used for evaluation.

Abbreviations: DC-CIK/chemo, DC-CIK immunotherapy combined with chemotherapy; Chemo, chemotherapy alone; DFS, disease-free survival.

Figure 7 Mean DFS rates in the combination therapy (DC-CIK/chemo) and control (chemo) groups.

Notes: A paired t-test was used for statistical analysis (P=0.043; P-values less than 0.05 were considered significant).

Abbreviations: DC-CIK/chemo, DC-CIK immunotherapy combined with chemotherapy; Chemo, chemotherapy alone; DFS, disease-free survival.

Table 2 Adverse effects after DC vaccine and CIK cell therapy combined with chemotherapy

Study	Combined therapy	Chemotherapy only
Gao et al^Citation8	Fever (33%)	Unknown
	Anorexia (53.73%)	Anorexia (96.69%)
	Leukopenia (43.28%)	Leukopenia (80.17%)
Lin et al^Citation17	Thrombocytopenia (43.28%)	Thrombocytopenia (84.47%)
	Nausea, vomiting (58.21%)	Nausea, vomiting (58.21%)
	Abnormal liver function (41.04%)	Abnormal liver function (70.25%)
	Fever (38.57%)
	Insomnia (47.14%)
Niu et al^Citation25	Anorexia (38.57%)	Unknown
	Joint soreness (4.29%)
	Skin rash (11.43%)
	Fever (29.5%)
	Insomnia (19.2%)
Zhu et al^Citation54	Anorexia (9.1%)	Unknown
	Joint soreness (5.4%)
	Skin rash (1%)

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