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Meta-Analysis
. 2013 May 7;8(5):e62847.
doi: 10.1371/journal.pone.0062847. Print 2013.

Adoptive cellular immunotherapy in metastatic renal cell carcinoma: a systematic review and meta-analysis

Xiaoyi Tang  1 , Ting Liu, Xuefeng Zang, Hao Liu, Danhong Wang, Hu Chen, Bin Zhang
Affiliations
Meta-Analysis

Adoptive cellular immunotherapy in metastatic renal cell carcinoma: a systematic review and meta-analysis

Xiaoyi Tang et al. PLoS One. .

Abstract

Purpose: Metastatic renal cell carcinoma (mRCC), as one of the most immunogenic tumors has been the focus of adoptive cellular immunotherapy (ACI), but the effects of ACI on objective response and survival in patients with mRCC are still controversial. Therefore, a systematic review and meta-analysis was performed to address this issue.

Methods: A search was conducted in the PubMed database for randomized clinical trials (RCTs) with ACI in mRCC. All included articles in this study were assessed according to the selection criteria and were divided into two groups: ACI versus no ACI. Outcomes were toxicity, objective response, 1-, 3- and 5-year survival. Risk ratio (RR) and 95% confidence intervals (CI) were calculated using a fixed-effects meta-analysis. Heterogeneity was measured by value of I(2) or P.

Results: 4 studies (469 patients) were included. Most of ACI-related adverse reactions were grade 1 or 2 and reversible. ACI provided significant benefit in terms of objective response (RR = 1.65; 95% CI, 1.15 to 2.38; P = 0.007, I(2) = 49%), 1-year survival (RR = 1.30; 95% CI, 1.12 to 1.52; P = 0.0008, I(2) = 0%), 3-year survival (RR = 2.76; 95% CI, 1.85 to 4.14; P<0.00001, I(2) = 46%) and 5-year survival (RR = 2.42; 95% CI, 1.21 to 4.83; P = 0.01, I(2) = 28%).

Conclusions: ACI may be a safe and effective treatment for improving objective response, 1-, 3- and 5-year survival in patients with mRCC. Besides, five obstacles for ACI, including high degree of personalization, unsuitable WHO/RECIST response criteria, inadequate identification of tumor-associated antigens (TAAs), lack of effective combination treatments and less attention paid to the quality of ACI products, should be overcome during the successful development of more potent ACI for cancer in the future.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram showing record identification, record screening,full text article eligibility and study inclusion process.
Figure 2
Figure 2. Comparison of objective response between ACI and control (no ACI) groups.
Figure 3
Figure 3. Comparison of 1-year survival between ACI and control (no ACI) groups.
Figure 4
Figure 4. Comparison of 3-year survival between ACI and control (no ACI) groups.
Figure 5
Figure 5. Comparison of 5-year survival between ACI and control (no ACI) groups.
See this image and copyright information in PMC

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