Purpose. To observe the remission rate and side effects of immunotherapy combined with radiotherapy in patients with brain metastasis of driver gene-negative non-small-cell lung cancer (NSCLC). Methods. 152 patients with NSCLC brain metastasis admitted to our hospital from January 2019 to December 2021 were selected as the research objects. Patients were divided into a single group (85 cases) and a combined group (67 cases) according to treatment methods. The therapeutic effects and side effects of the single group and combined group were compared. In addition, the patients who received immunotherapy combined with radiotherapy were divided into three subgroups: A, B, and C, and the therapeutic effects and side effects of different radiotherapy modes were compared among group A [whole brain radiotherapy (WBRT)], group B (WBRT combined with local radiotherapy) and group C (local radiotherapy). Results. The objective response rate (ORR) and disease control rate (DCR) in the combined group were higher than those in the single group ( P < 0.05 ). The incidence of reactive capillary hyperplasia and immune-related pneumonia in the combined group were higher than that in the single group ( P < 0.05 ). There was no significant difference in the incidence of other side effects between the two groups ( P > 0.05 ). ORR and DCR in group B were higher than those in group A ( P < 0.05 ). There was no significant difference in the incidence of side effects among the three groups ( P > 0.05 ). Conclusion. Immunotherapy combined with radiotherapy is effective in patients with brain metastasis of driver gene-negative NSCLC, which can improve the disease control rate without increasing the side effects. In addition, WBRT combined with local push radiotherapy is effective and safe. Clinical Study Registration Number. The Clinical study registration number is K2019086.
Tumor cell lysate (TCL)-based vaccines contain a large number of tumor-specific and related antigens, albeit at low levels, that require active transfer and presentation by antigen-presenting cells (APCs) in vivo, which stimulate a weak immune response. The artificial APC (aAPC) system presented herein is a cell-based therapeutic system that can significantly enhance the immune response compared to TCL-based vaccines. This study combines these two treatment strategies to assess their in vitro and in vivo effects. We successfully prepared TCL-poly(lactic-co-glycolic acid)-PEI (TPP) and demonstrated that it was phagocytosed by the APCs and enhanced the maturation of DCs in vitro. The use of TPP in combination with the aAPCs resulted in better antitumor effects compared to the individual therapies. The combination therapy induced a higher proportion of CD4+ T, CD8+ T, and TRP2180–188-specific CD8+ T cells in comparison with the individual therapies. Additionally, the combination therapy enhanced the in vitro proliferation activity; greater inhibited regulatory T cells; and promoted inflammatory cytokine secretion, while reduced the production of inhibitory cytokines. In conclusion, the combination therapy consisting of the TPP tumor nanovaccine and the aAPC system enabled a broader immune response and achieve better antitumor effects compared to treatment with the individual therapies.
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