title: HLA antigen as predictive index for the outcome of breast cancer patients with adjuvant immunochemotherapy with PSK.
abstract: We demonstrated that the prognosis of breast cancer patients who received adjuvant immunochemotherapy with Krestin (PSK) showed a tendency to be better than that of breast cancer patients receiving chemotherapy only. We retrospectively investigated the usefulness of HLA typing for selecting patients to receive adjuvant immuno-chemotherapy with PSK. One hundred and thirty-four patients with operable breast cancer were typed as HLA-A, -B, -C by a lymphocytotoxicity test. Patients without vascular invasion had no adjuvant therapy (NA group). Patients with vascular invasion in the tumor and/or in the metastatic lymph node were randomized into two groups. In group 1 (FEMP only), a combination chemotherapy of 100 mg of 5-fluorouracil (F), 50 mg of cyclophosphamide (E), 2 mg of mitomycin C (M), and 5 mg of predonisolone (P) was orally administered daily for 28 days (one course). In group 2 (FEMP+PSK), FEMP and 3.0 g of PSK were orally administered for 28 days (one course). Two courses a year of these agents were given for five years in both groups. Each group (NA, FEMP, FEMP+PSK) was stratified by the presence of HLA B40 type (B40(+)) or not (B40(-)). Five- and 10-year disease-free survival (DFS) rates (93%, 80%, respectively) of patients with B40(+) seemed to be better than those (83% and 51%) of patients with B40(-). In the NA group, 5- and 10-year DFS were 100% and 71% in patients with B40(+), 92% and 76% in those with B40(-), respectively. In the FEMP group (chemotherapy only), 5- and 10-year DFS of patients with B40(+) were both 84%. These were not statistically significant compared with those (82% and 33%) of patients with B40(-). On the other hand, in the FEMP+PSK group, 5- and 10-year DFS of patients with B40(+) were both 100%, and those of patients with B40(-) were 76% and 55%, respectively. DFS of patients with B40(+) was significantly better than that of patients with B40(-). It is concluded that HLA typing may be a predictive index in determining the use of immunochemotherapy combined with PSK for patients with operable breast cancer.
authors.affiliation: Department of Emergency and Critical Care Medicine, Gunma University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yokoe
authors.forename: Y
authors.initials: Y
authors.lastname: Iino
authors.forename: H
authors.initials: H
authors.lastname: Takei
authors.forename: J
authors.initials: J
authors.lastname: Horiguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Koibuchi
authors.forename: M
authors.initials: M
authors.lastname: Maemura
authors.forename: S
authors.initials: S
authors.lastname: Ohwada
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006680:HLA Antigens / Q000032:analysis*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D011509:Proteoglycans / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000276:Adjuvants, Immunologic; D006680:HLA Antigens; D011509:Proteoglycans; C010770:polysaccharide-K