Cytokine-induced killer cells for the adjuvant treatment of patients with HCC

Abstract

The prognosis is still poor in patients with hepatocellular carcinoma (HCC). One of the reasons for poor prognosis is a frequent tumor recurrence from diseased remnant liver even after potentially curative treatment following early detection of tumor during regular surveillance for HCC. Until now, however, the benefit of any form of adjuvant therapy remains unclear, and current international practice guidelines do not recommend any adjuvant therapy after curative treatment. Meanwhile, a recent randomized controlled trial showed that adjuvant cellular immunotherapy using cytokine-induced killer (CIK) cells is safe and prolongs both recurrence-free survival and overall survival in patients treated with curative treatment. CIK cells are a mixture of T lymphocytes, which are expanded ex vivo with cytokines, comprising CD3+/CD56+ cells, CD3-/CD56+ natural killer cells, and CD3+/CD56- cytotoxic T cells. Among them CD3+/CD56+ natural killer-like T cells have high proliferation rate and are the main effector cells killing tumor without major histocompatibility complex restriction. Several potential methods should be considered to improve the efficacy of CIK cell therapy. Now combination therapy with other cellular immunotherapy such as dendritic cell vaccines or immune checkpoint inhibitors is being investigated to enhance the efficacy of CIK cell immunotherapy.