摘要
目的:评价抗血管生成靶向药物甲磺酸阿帕替尼联合多靶点抗原肽自体免疫细胞技术(Multiple antigens specific cell therapy,MASCTTM)治疗肉瘤的临床有效性和安全性。方法:收集6例经手术、放化疗治疗失败或拒绝手术、放化疗治疗的肉瘤患者,且治疗结束至少1个月以上。其中4例患者至少接受3周期MASCTTM治疗,并在第1天给予阿帕替尼500 mg,po,qd,口服至疾病进展,评价近期疗效和无进展生存时间(PFS)。其中2例单独使用甲磺酸阿帕替尼的患者为对照。检测患者的细胞免疫功能、外周血循环肿瘤细胞数(CTCs),并对患者进行生活质量测评,3周期MASCT TM治疗结束后1个月进行ELISPOT检测,治疗全程中记录患者的不良反应。结果:4例联合治疗患者均完成3周期治疗,其中1例患者治疗2周期后出现Ⅳ度手足综合征,改阿帕替尼为250 mg,po,qd后可耐受。治疗后1例患者为CR,3例为PR;4例患者的淋巴细胞免疫功能均有改善,CTCs数量明显减少,生活质量均较治疗前明显改善,未见有严重不良反应。ELISPOT检测提示患者对其中大部分的抗原肽有特异性响应(≥10/15种),4例患者PFS分别为7、6、9、4个月;2例单独使用阿帕替尼的患者1例SD,1例PD,PFS分别为1、2个月。结论:应用阿帕替尼联合MASCTTM技术对骨与软组织肉瘤患者安全、有效,具有良好的应用前景。
Objective： To evaluate the effect and safety of molecular targeted therapy of apatinib mesylate combined with multiple antigen stimulatiing cellular therapy in treatment of osteosarcoma and soft tissue sarcoma. Methods： Six patients with sarcoma were collected by the failure of surgery,radiation and chemotherapy treatment or refusal surgery,radiation and chemotherapy,and at least one month from the last treatment of surgery,radiation and chemotherapy. All of the patients at least received three cycle MASCTTM. From Day 1,everyone were given Apatinib 500 mg,po,qd,until the disease progression. To measure the patient＇s quality of life depending on EORTC QLQ-C30,meanwhile,detecting the cellular immunity function and circulating tumor cells（ CTCs） of patients before treatment and one month after 3 cycle MASCTTM. At last,monitoring the cellular immune responses by the Enzyme-linked immuno spot（ ELISPOT） assay. Results： All of the four patients completed the treatment of 3 cycle MASCTTM. Only one patient reduced apatinib from 500 mg to 250 mg because of palmar-plantar erythrodyses-thesia. The response rates of the four patients received MASCTTMand apatinib mesylate after treatment were 1 for complete response（ CR）,3 for partial response（ PR）. The life quality and cellular immunity function were improved in all of the patients. ELISPOT assay suggested that the majority of antigen peptides could induce specific cytotoxic T lymphocytes（ CTLs） response. The Progression-Free-Survival（ PFS） of four patients received MASCTTMand apatinib mesylate was 7,6,9 and 4 months,while the response rates of the two patients received apatinib mesylate were 1 for（ Stable disease） SD,one for（ Progression disease） PD. And PFS of the two patients were one month and two months. Conclusion： Combination of MASCTTMand apatinib mesylate is safe,effective and were good prospects for application.
作者
乔云
惠开元
任岩
王磊
宋大安
蒋晓东
QIAO Yun HUI Kai-Yuan REN Yan WANG Lei SONG Da-An JIANG Xiao-Dong.(Department of Radiation Oncology, the Affiliated Lianyungang Hospital of Xuzhou Medical University/the First People＇s Hospital of Lianyungang , Lianyungang 222002, Chin)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2017年第1期114-119,共6页
Chinese Journal of Immunology
