Experience of Autologous Immunotherapy for Non-Small Cell Lung Cancer Using Zoledronate-Actived Gammadelta T Cells.

BACKGROUND: Several nations around the world have utilized autologous immune enhancement therapy in the treatment of cancer, with initial positive outcomes. This study describes our experience with autologous gamma delta T cell immunotherapy for the treatment of non-small cell lung cancer patients in Vietnam, a developing nation. METHODS: Five patients with non-small cell lung cancer at stages III - IV were enrolled in the study. Each patient received six infusions of autologous γδT cells, separated by two weeks. Before, during, at the end of treatment, and three and six months after treatment, a comprehensive evaluation of clinical, laboratory, quality of life, and adverse events related to the method was conducted. RESULTS: At the time of culture seeding, the total number of cells ranged from 2.9 to 18.2 x 106, with γδT cells ranging in number from 10.7 to 19.6 x 104. On day 14 of the culture, the number of γδT cells ranged from 3.1 to 8.3 x 108. Regarding the safety of therapy in a total of 30 infusions, two (fever), one (myalgia), and one (joint pain) were graded as 1 by CTCAE criteria. After the course, no toxicity was observed in the hematopoietic system, kidney function, or liver function. Evaluation of the patient's response in accordance with the RECIST 1.1 criteria: 20% of patients (one patient) had partial response disease, and 80% of patients (four patients) had stable disease at the end of treatment. During the follow-up period of the study, three patients were still alive, and the disease remained stable. The patient's quality of life improved after treatment in most functional measures (activity, cognitive, and social), but physical and emotional scores decreased slightly. Two patients' fatigue symptoms increased, but after six months of treatment, the average value dropped from 25.3 to 8.3. Dyspnea symptoms decreased gradually from 33.3 at the start of treatment to 8.3 six months later. CONCLUSIONS: The initial results we obtained regarding the efficacy and safety of autologous γδT cell immunotherapy for patients with non-small cell lung cancer are extremely encouraging and comparable to those of previous studies.

A case of response to combination treatment with autologous immunotherapy and bevacizumab in advanced non-small cell lung cancer.

Natural killer (NK) cells have developed as a potent tool in cancer immunotherapy. Especially, patients who have failed in the first-line or maintenance treatment received a good response with immunotherapy in association with other approaches. We report the case of a 61-year-old male patient with programmed cell death ligand - 1(PD-L1) expression in advanced non-small cell lung cancer (NSCLC) (stage IV). Even though the patient was treated with standard therapy using keytruda, he still appeared with new lesions. Therefore, the patient was treated in combination with autologous NK cells therapy, gemcitabine, bevacizumab. NK cells were expanded from peripheral blood mononuclear cells (PBMCs) of the patient, and after that, they were transferred back to the patient. After 6 infusions of autologous NK cells in combination with gemcitabine, bevacizumab, the patient decreased significantly the size of primary, metastatic lesions and had a marked improvement in the quality of life. Besides, during combination therapy, no side effects have been reported and there was no toxicity observed in the hematopoietic system, liver as well as kidneys. Our case suggests that this treatment regimen is a potential treatment approach for advanced NSCLC with PD-L1 expression.

Prolonged Duration of Therapy Is Associated With Improved Survival in Patients Treated for Relapsed/Refractory Multiple Myeloma in Routine Clinical Care in the United States.

BACKGROUND: In clinical trials, an extended therapy duration has been associated with better outcomes in patients with newly diagnosed multiple myeloma (NDMM). However, data on how the therapy duration affects the outcomes for patients with relapsed/refractory multiple myeloma (RRMM) are limited. We conducted a large, retrospective study in the United States to evaluate the effect of the duration of second-line therapy on overall survival. PATIENTS AND METHODS: Adults with NDMM from January 2008 to June 2015 were followed up to identify their second-line therapy. The duration of therapy (DOT) and time to next therapy (TTNT), as a proxy for progression-free survival, were estimated using the Kaplan-Meier method. The relationship between the duration of second-line therapy and overall survival was evaluated with a logistic marginal structural model to mitigate the risk of treatment selection and survival bias. RESULTS: A total of 628 NDMM patients developed a relapse after initial therapy. The median DOT for second-line therapy was 6.9 months (95% confidence interval [CI], 5.9-7.7 months), which was shorter than the corresponding TTNT (median, 15.1 months; 95% CI, 13.4-17.3 months). Each additional month of second-line therapy was associated with a reduced adjusted risk of death at 1 year (odds ratio, 0.78; 95% CI, 0.77-0.83; P < .001). CONCLUSION: In a large database capturing a heterogeneous patient population and varied treatment patterns reflecting routine clinical care, we found a clinical benefit for continued longer DOT at first relapse. Despite the emerging paradigm favoring continuous therapy, second-line progression-free survival (utilizing TTNT as the proxy) was more than twofold longer than the DOT. Understanding the barriers to extended DOT could help to improve the outcomes for RRMM patients.