Crucial Role of Lymphocytes in the Therapeutic Efficacy of Dendritic Cell Immunotherapy for Advanced Hepatocellular Carcinoma.

At present, immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) are used to treat advanced hepatocellular carcinoma (HCC), with limited therapeutic effects. Dendritic cell (DC) immunotherapy may be a feasible option following ICI/TKI therapy to increase patient survival. Seventy patients with HCC who received DC therapy were included in this study. DCs were propagated from peripheral blood monocytes and pulsed with tumor lysate. The phenotypes of peripheral white blood cells were analyzed prior to and after DC therapy. Among the 70 patients examined, 11 (15.7%) had an objective response (group A), 26 (37.1%) had stable disease and minor regression (group B), 21 (30.0%) had stable disease and minor progression (group C), and 12 (17.1%) had progressive disease (group D). Prior to DC therapy, patients in group A had a higher frequency of CD8+ T-cells and a lower neutrophil-to-lymphocyte ratio than patients in the other groups. After DC therapy, patients in groups A and B exhibited a significant increase or tendency to increase in the frequencies of CD3+, CD4+, and CD8+ T-cells. The 1-, 2-, and 3-year survival rates were 90.9%, 81.8%, and 63.3%, respectively, for group A patients; 76.9%, 50.5%, and 26.9% for group B patients, which were significantly better than the rates of 42.9%, 9.5%, and 4.8% for group C patients and 25%, 8.3%, and 0% for group D patients (p < 0.001). In conclusion, DC therapy following ICI/TKI therapy is feasible for patients with advanced HCC. Patients with objective or minor responses to DC therapy exhibited an increased frequency of T-cells and improved survival.