Combined immunotherapy with intracavital injection of activated lymphocytes, monocyte-derived dendritic cells and low-dose OK-432 in patients with malignant effusion.
We have conducted a pilot study with combined immunotherapy using autologous lymphocytes activated ex vivo and monocyte-derived dendritic cells in combination with low-dose OK-432, a streptococcal preparation, in five patients with peritoneal or pleural carcinomatosis who were resistant to standard chemotherapy. All patients were given 3 to 10 courses of the combined immunotherapy. No severe adverse reactions occurred. Effusion production was decreased in all of the patients. Significant decreases in tumor markers of both effusions and sera as well as effusion volume occurred in all of the patients. Cytological examinations revealed a marked decrease or disappearance of cancer cells in those effusions. Three patients showed increase in IFN-gamma levels in the effusions. The overall prognosis of the patients was acceptable and the mean survival time was more than 9 months. The locoregional immunotherapy seems to be encouraging in view of therapeutic modality in patients who are resistant to standard chemotherapy. Our study provides a new protocol for immunotherapy and warrants further phase I/II clinical study for chemo-resistant patients with malignant effusion.
Morisaki
Takashi
T
Department of Cancer Therapy and Research, Collaboration Center, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582.
Matsumoto
Kotaro
K
Kuroki
Hideo
H
Kubo
Makoto
M
Baba
Eishi
E
Onishi
Hideya
H
Tasaki
Akira
A
Nakamura
Mitsunari
M
Inaba
Syoichi
S
Katano
Mitsuo
M
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000276:immunology / Q000627:therapeutic use*; D001202:Ascitic Fluid / Q000276:immunology / Q000628:therapy*; D001943:Breast Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D003713:Dendritic Cells / Q000276:immunology*; D005260:Female; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods*; D008213:Lymphocyte Activation / Q000276:immunology; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology; D010844:Picibanil / Q000276:immunology / Q000627:therapeutic use*; D010865:Pilot Projects; D016066:Pleural Effusion, Malignant / Q000276:immunology / Q000628:therapy*; D013274:Stomach Neoplasms / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology*
D000970:Antineoplastic Agents; D010844:Picibanil