A long-term survivor case of malignant mesothelioma treated by recombinant tumor necrosis factor-SAM2 (TNF-alpha mutein) and 5-fluorouracil (5-FU): a new therapeutic approach based on host-tumor relationship.
BACKGROUND
The prognosis of mesothelioma is very poor, and there is no established method to suppress tumor growth. Immunological approaches have recently been thought to be effective for mesothelioma and several studies using cytokines have been performed. We used a novel recombinant tumor necrosis factor-alpha (rTNF-alpha) we called rTNF-SAM2, in the treatment of a patient with this disease.


METHODS
A 48-year old male patient with ascites was diagnosed with malignant mesothelioma by cytological examination. TNF-SAM2 in an amount of 264 to 576 micrograms (1 to 2.2 x 10(6) U) was injected via a catheter several times. Five hundred mg of 5 fluorouracil (5-FU) was also given via catheter once a week and 5-FU derivative was given orally every day.


RESULTS
No apparent tumor progression was observed for 6 years and 6 months and the patient led a normal life. During the therapy, the malignancy of tumor cells from the ascites changed from class V to class VI.


CONCLUSIONS
TNF based therapy may be promising treatment for the suppression of malignant mesothelioma.
Takagi
K
K
Division of Surgery, Coloproctology Center, Takano Hospital, Kumamoto, Japan.
Fukushima
Y
Y
Kanou
J
J
Honda
T
T
Tomita
K
K
Takano
M
M
Soma
G
G
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001201:Ascites; D001483:Base Sequence; D003131:Combined Modality Therapy; D017931:DNA Primers; D005091:Exons; D005472:Fluorouracil / Q000627:therapeutic use*; D016158:Genes, p53; D011905:Genes, ras; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D018807:Polymorphism, Single-Stranded Conformational; D011994:Recombinant Proteins / Q000009:adverse effects / Q000096:biosynthesis / Q000627:therapeutic use; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017741:Survivors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014407:Tumor Cells, Cultured; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects / Q000096:biosynthesis / Q000235:genetics / Q000627:therapeutic use*
D000964:Antimetabolites, Antineoplastic; D017931:DNA Primers; D011994:Recombinant Proteins; C109083:TNF-SAM2; D014409:Tumor Necrosis Factor-alpha; D005472:Fluorouracil