Background Postsurgical recurrence of hepatocellular carcinoma (HCC) is frequent and fatal. Adoptive immunotherapy is active against HCC. We assessed whether postoperative immunotherapy could lower the frequency of reccurence.Method Between 1992 and 1995, we did a randomised traial in which 150 patients who had undergone curative resection for HCC were assigned adoptive immunotherapy(n=76) or no adjuvant treatment(n=74). Autologous lymphocytes activated vitro with recombinant interleukin-2 and antibody to CD3 were infused five times during the first 6 months. Primary endpoints were time to first recurrence and recurrence-free survival and analyses were by intention to treat.Finding 76 patients received 370(97%) of 380 scheduled lymphocyte infusion (mean cell number per patient 7.1×10１０[SD 2.1]; CD3 and HLA-DR cells 78%), and none had grade 3 or 4 adverse events. After a median follow-up of 4.4 years (range 0.2-6.7), adoptive immunotherapy decreased the frequency of recurrence by 18% compared with controls(45% vs 57%) and reduced the risk of recurrence in the immunotherapy group was significantly longer than that in the control group (48%[37-59] vs 33%[22-43] at 3 years, 38%[22-54] vs 22%[11-34] at 5 years; p=0.008). The immunotherapy group had significantly longer recurrence-free survival(p=0.01) and disease-specific survival(p=0.04) than the control group. Overall survival did not differ significantly between groups(p=0.09).Interpretation Adoptive immunotherapy is a safe, feasible treatment that can lower recurrence and improve recurrence-free outcomes after surgery of HCC.
<題目> Adjuvant Adoptive Immunotherapy Against Hepatocellular Carcinoma Tadatoshi Takayama, Teruaki Sekine, Yasushi Kondo, Tadao Kakizoe(Depatments of Surgery and Experimental Medicine National Cancer Center) Masatoshi Makuuchi(Second Department of Surgery University of Tokyo)