Dendritic cell-cytokine killer combined with microwave ablation reduced recurrence for hepatocellular carcinoma compared to ablation alone

Abstract

BACKGROUND:

Several international practice guidelines have recommended local ablation as the first-line treatment for early-stage hepatocellular carcinoma (HCC).

OBJECTIVE:

This study aims to investigate the synergetic anti-tumor impact of dendritic cell-cytokine killer (DC-CIK) combined with microwave ablation (MWA) for HCC.

METHODS:

This retrospective study included 1,141 patients from the American Joint Committee on Cancer stage I-II HCC, who were treated with therapeutic MWA. The immunotherapy group encompassing 40 patients received additional immunotherapy with DC-CIK, whereas the control group consisting of 1,101 patients was treated with MWA alone. Propensity score matching (PSM) with ratio of 1:3 was employed to balance selection bias. The oncological outcome and immune status were measured after combination therapy.

RESULTS:

The immunotherapy group patients exhibited significant longer disease-free survival (DFS, primary HCC: $p=$ 0.036; recurrent HCC: $p=$ 0.026). For patients with primary HCC, the recurrence frequency was reduced ( $p=$ 0.002), and recurrence interval (19 months vs. 9 months, $p<$ 0.001) was prolonged in the immunotherapy group. Subgroup analysis revealed that patients $⩽$ 60 years old, moderately-differentiated HCC, or co-infected with Hepatitis B Virus (HBV) had a significant benefit over DFS in the immunotherapy group. After combination therapy, the serum CD3 $+$ ( $p=$ 0.049), CD8/CD28 $+$ ( $p=$ 0.045) were elevated.

CONCLUSION:

Combination therapy with DC-CIK and MWA can significantly reduce the recurrence and prolong DFS, especially for patients $⩽$ 60 years old or with moderately-differentiated HCC or co-infected with HBV.