Adjuvant cellular immunotherapy in patients with resected primary non-small cell lung cancer

Figures & data

Table 1. Distribution of demographic and clinical characteristics of patients in the control and cellular immunotherapy (CIT) groups

Variables	Control group (n = 60)	CIT group (n = 60)	p value
Age (years)	57.58 ± 10.03	58.30 ± 11.59	0.813
Gender			0.224
Male	46	40
Female	14	20
Smoking index			0.463
< 400	29	35
≥ 400	31	25
Pathological category			1.000
Adenocarcinoma	44	44
Squamous carcinoma	16	16
Pathologic grade			0.311
1	5	5
2	22	30
3	33	25
Tumor stage			0.644
I	22	25
II+IIIa	31	26
IIIb+IV	7	9
Lymph node metastasis			0.584
Yes	28	31
No	32	29

Abbreviations: CIT, cellular immunotherapy.

Table 2. Distribution of demographic and clinical characteristics of patients in the CIK and CIK+NK groups

Variables	CIK group (n = 33)	CIK + NK group (n = 27)	p value
Age (years)	58.33 ± 11.64	58.26 ± 11.74	0.947
Gender			0.271
Male	24	16
Female	9	11
Smoking index			0.236
< 400	17	18
≥ 400	16	9
Pathological category			0.060
Adenocarcinoma	21	23
Squamous carcinoma	12	4
Pathologic grade			1.000^*
1	3	2
2	16	14
3	14	11
Tumor stage			0.392^*
I	11	14
II+IIIa	16	10
IIIb+IV	6	3
Lymph node metastasis			0.622
Yes	18	13
No	15	14

Abbreviations: CIK, cytokine-induced killer cells; NK, natural killer cells; CIT, cellular immunotherapy.

* Fisher's exact test.

Figure 1. Phenotypic analysis of immune cells after expansion. (A) The percentage of CIK cells (CD3⁺CD56⁺) after induction in one of the patients. (B) The percentage of NK cells (CD3^–CD56⁺) after the 14-d culture.

Figure 2. Survival analysis in patients with NSCLC. (A) Overall survival curves for NSCLC patients (n = 120) who received adjuvant cellular immunotherapy (CIT) combined with chemotherapy (CIT group, n = 60) or chemotherapy alone (control group, n = 60). (B) Overall survival curves for NSCLC patients who received adjuvant CIK cell treatment (CIK group, n = 33), adjuvant CIK cell and NK cell treatment (CIK + NK group, n = 27), or chemotherapy alone (control group, n = 60).

Table 3. Univariate and multivariate analysis of overall survival in patients with NSCLC

	Univariate analysis		Multivariate analysis
Variables	HR (95 % CI)	p value	HR (95 % CI)	p value
Age (>60 vs. ≤ 60)	0.948 (0.494–1.818)	0.872
Gender (male vs. female)	2.344 (0.978–5.616)	0.056
Smoking index (≥400 vs. <400)	1.350 (0.711–2.564)	0.359
Pathological category (Sq. vs. Ad.)	0.887 (0.429–1.834)	0.746
Pathologic grade (1, 2 vs. 3)	1.296 (0.833–2.018)	0.251
Tumor stage (II, III, IV vs. I )	2.093(1.035–4.231)	0.040^a	1.212(0.417–3.518)	0.724
Lymph node metastasis (Yes vs. No)	2.159 (1.115–4.180)	0.022^a	2.147 (1.109–4.154)	0.023^a
Treatment (CIT vs. control)	0.476(0.244–0.932)	0.030^a	0.479 (0.245–0.937)	0.031^a

^a p < 0.05.

Abbreviations: NSCLC, non-small cell lung cancer; HR, hazard ratio; CI, confidence interval; Sq., Squamous carcinoma; Ad., Adenocarcinoma; CIT, cellular immunotherapy.

Table 4. Univariate and multivariate analysis of overall survival for patients in the CIK and CIK+NK groups

	Univariate analysis		Multivariate analysis
Variables	HR (95 % CI)	p value	HR (95 % CI)	p value
Age (>60 vs. ≤ 60)	3.803 (1.222–11.841)	0.021^a	4.009(1.230–13.060)	0.021^a
Gender (male vs. female)	2.678 (0.590–12.152)	0.202
Smoking index (≥400 vs. <400)	1.710 (0.555–5.263)	0.350
Pathological category (Sq. vs. Ad.)	0.885 (0.267–2.932)	0.842
Pathologic grade (1, 2 vs. 3)	0.778 (0.251–2.412)	0.664
Tumor stage (II, III, IV vs. I )	1.742 (0.564–5.381)	0.335
Lymph node metastasis (Yes vs. No)	1.598 (0.531–4.808)	0.404
Treatment (CIK+NK vs. CIK)	0.280(0.082–0.953)	0.042^a	0.261 (0.072–0.947)	0.041^a

^a p < 0.05.

Abbreviations: NSCLC, non-small cell lung cancer; HR, hazard ratio; CI, confidence interval; Sq., Squamous carcinoma; Ad., Adenocarcinoma; CIK, cytokine-induced killer cells; NK, natural killer cells.

Figure 3. Subgroup analysis to estimate the benefits of additional cellular immunotherapy (CIT). (A) Overall survival curves for NSCLC patients with lymph node negative (n = 61) who received adjuvant CIT combined with chemotherapy (CIT group, n = 29) or chemotherapy alone (control group, n = 32). (B) Overall survival curves for NSCLC patients with lymph node positive (n = 59) who received adjuvant CIT combined with chemotherapy (CIT group, n = 31) or chemotherapy alone (control group, n = 28). (C) The Kaplan-Meier method was used to compare the overall survival rates between the ≤ 60-y-old group (n = 36) and > 60 age group (n = 24).