[Preliminary results of cytotoxic monoclonal antibody treatment in pancreatic adenocarcinomas and biliary tract carcinomas].
Fifteen patients with biliopancreatic carcinoma were treated by monoclonal antibodies (12 pancreatic adenocarcinomas, 3 bile duct carcinomas). In 7 cases, a tumor resection was associated with immunotherapy: 5 partial pancreatic resections for stage III and IV disease, according to Hermreck's classification, and 2 biliary resections (Whipple resection for distal duct tumor, biliary and liver resection for proximal bile duct tumor). We use the 17-1.A antibody, an IgG-2a murine monoclonal antibody, either isolated (6 cases) or in association with other monoclonal antibodies (4 cases) or gamma IFN (5 cases). All of these patients underwent leukapheresis. Response to 17-1.A therapy was evaluated by laboratory tests (CA 19-9) and by morphological investigations (US, CT, radioimmunolocalization scanning). The median survival of patients with unresectable pancreatic carcinoma (7 cases), was 7.4 months. For pancreatic adenocarcinoma, treated by resection associated with immunotherapy (5 cases), the median survival was 21 months. Monoclonal antibody therapy was effective in a third of evaluated pancreatic adenocarcinomas (4 clear objective responses) but only transiently except in one patient still alive after 57 months. The low rate of therapeutic responses may been attributed to inadequate doses and the development of human anti-murine antibodies.
Leborgne
J
J
Clinique Chirurgicale A., Hôtel-Dieu, Nantes.
Douillard
J Y
JY
Kremer
M
M
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery
D000911:Antibodies, Monoclonal
Résultats préliminaires du traitement par anticorps monoclonaux cytotoxiques dans les adénocarcinomes pancréatiques et les carcinomas biliaires.