Autologous Cytokine-induced Killer Cell Combination Therapy Enhances Response to Immune Checkpoint Inhibitors in Patients with Refractory Clear Cell Renal Cell Carcinoma
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Background : Clear cell renal cell carcinoma (ccRCC) remains a challenging malignancy to treat, with immune checkpoint inhibitors (ICIs) revolutionizing patient management. This clinical study, involving a small cohort, evaluated the efficacy and safety of combination therapy comprising camrelizumab, an anti-PD-1 antibody, and autologous cytokine-induced killer (CIK) cell therapy in patients with refractory ccRCC. Methods : Twenty-one patients with refractory ccRCC were randomly assigned to receive either camrelizumab monotherapy (control group, n=12) or camrelizumab combined with CIK cell re-transfusion (trial group, n=9). The objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety were evaluated. Biomarker exploration was performed using peripheral blood samples from patients. Results : The ORR was higher in the trial group (55.6%) compared to the control group (41.7%). The median PFS and OS in the trial group were 28.50 months and not reached, respectively, whereas in the control group, these values were 8.67 months and 57.47 months, respectively. One patient in the trial group achieved a complete metabolic response (CMR). No new safety signals were observed, and CIK cell re-transfusion did not increase the frequency of adverse effects. Higher baseline PD-1 expression on CD8 + T cells in the peripheral blood was associated with a better response, and PD-1 positive frequency decreased after camrelizumab administration. Conclusions : CIK cell therapy enhances the antitumor efficacy of anti-PD-1 antibody therapy in refractory ccRCC with tolerable adverse effects. Further investigation should focus on the combination of ICIs, antiangiogenic agents, and CIK cell re-transfusion as first-line therapy for metastatic or advanced ccRCC. Registry : ClinicalTrials.gov, TRN: NCT03987698, Registration date: 17 June 2019.
