Liver Cancer Clinical Trial
Official title:
Evaluation of Cytokine-induced Killer (CIK) Cells as Therapy or Adjuvant Treatment for Patients With Advanced Hepatocelluler Carcinoma
Hepatocellular carcinoma (HCC) is the fifth most common malignancy in the world and the
third most common cause of cancer-related deaths complicating liver cirrhosis in most cases.
In Egypt, there has been a remarkable increase of the proportion of HCC among CLD patients
from 4.0% to 7.2% over a decade. This rising proportion may be explained by the increasing
risk factors such as the emergence of HCV over the same period of time, the contribution of
HBV infection, improvement of the screening programs and diagnostic tools of HCC as well as
the increased survival rate among patients with cirrhosis to allow time for some of them to
develop HCC. The only curative treatment modalities for HCC are surgery, local ablation, and
liver transplantation which have high recurrence rate either due to viral hepatitis
infection or cirrhosis leading to low success rate and high economic burden.
Unfortunately, the majority of patients have unresectable disease at diagnosis. So, patients
search for palliative very expensive therapies including chemotherapy and radiotherapy which
often fail to eradicate tumor lesions completely and tend to result in many adverse
events.Thus, novel approaches for treatment options are needed for patients with advanced
HCC .
In recent years, immunotherapy has emerged as an efficacious treatment modality with
encouraging efficacy and slight adverse events in cancer therapy [Stroncek 2010].
Cytokine-induced killer CIK cells therapy has been evaluated as an adoptive cell
immunotherapy for cancer patients in a number of clinical trials and the promising efficacy
of CIK cells on malignancies has been proved.
Hepatocellular carcinoma (HCC) is the fifth most common malignancy in the world and the
third most common cause of cancer-related deaths complicating liver cirrhosis in most cases.
In Egypt, there has been a remarkable increase of the proportion of HCC among CLD patients
from 4.0% to 7.2% over a decade. This rising proportion may be explained by the increasing
risk factors such as the emergence of HCV over the same period of time, the contribution of
HBV infection, improvement of the screening programs and diagnostic tools of HCC as well as
the increased survival rate among patients with cirrhosis to allow time for some of them to
develop HCC. The only curative treatment modalities for HCC are surgery, local ablation, and
liver transplantation which have high recurrence rate either due to viral hepatitis
infection or cirrhosis leading to low success rate and high economic burden..
Unfortunately, the majority of patients have unresectable disease at diagnosis. So, patients
search for palliative very expensive therapies including chemotherapy and radiotherapy which
often fail to eradicate tumor lesions completely and tend to result in many adverse
events.Thus, novel approaches for treatment options are needed for patients with advanced
HCC .
In recent years, immunotherapy has emerged as an efficacious treatment modality with
encouraging efficacy and slight adverse events in cancer therapy. Cytokine-induced killer
CIK cells therapy has been evaluated as an adoptive cell immunotherapy for cancer patients
in a number of clinical trials and the promising efficacy of CIK cells on malignancies has
been proved. . Clinical studies have demonstrated that it is an excellent method to prevent
tumor recurrence and has preliminarily shown its efficacy in inhibiting recurrence and
metastasis of primary HCC -Peripheral blood mononuclear cells (PBMC)from patients with
primary HCC were incubated in vitro and induced into CIK cells in the presence of various
cytokines such as interferon-gamma (IFN-ã ), interleukin-1 (IL-1), IL-2, and monoclonal
antibody (mAb) against CD3. CIK cells infusion will be performed Once every week, with a
total of at least4infusions. Infusion will be given intrahepatic or via peripheral veins .
The serial biological events following CIK cells administration to a cancer patient includes
(a) immune activation and effective lymphocytes (mostly C D3+CD 5 6+Tlymphocytes)
proliferation starting early after the first administration , ( b) clinically measurable
antitumor effect mediated by activated immune cells over weeks to months ,and (c) potential
delayed effect on patient survival several months or even longer after the first
administration.
Our team have many grants in field of HCC biomarkers discovery and managements from NIH as
multicenter studies which got many international publication. As well as grant for the use
of laboratory techniques in the cultivation of stem cells for specialized cells used in the
treatment of different diseases which got publication in this era. we aim in this project to
cultivate patients cells in vitro to get CIK cells and study the safety and efficacy of
immunization with specific antihepatocellular carcinoma Cytokine -induced killer cells in
Egyptian patients with advanced hepatocellular carcinoma as treatment or adjuvant treatment
in comparison with traditional treatment.
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