title: Graft-versus-tumor effect against advanced pancreatic cancer after allogeneic reduced-intensity stem cell transplantation.
abstract: BACKGROUND
  The prognosis of advanced pancreatic cancer is extremely poor and therefore a novel treatment strategy is desired. The authors thus started a prospective study of allogeneic reduced-intensity hematopoietic stem cell transplantation (RIST) for patients with advanced pancreatic cancer to evaluate the feasibility and efficacy of this approach for such patients.
  
  
  METHODS
  Only patients with pathologically proven pancreatic cancer that was locally advanced or metastatic and not amenable to curative resection were included. The conditioning regimen consisted of gemcitabine, fludarabine, and busulfan.
  
  
  RESULTS
  In the first stage of this study, the authors treated seven patients. Treatment-related mortality before day 100 was observed in one patient. The median survival after RIST was 229 days. An objective response on computed tomographic scan was observed in two patients and another had a tumor marker response. Marked tumor shrinkage was observed in one of the remaining patients after donor lymphocyte infusion. These antitumor effects appeared after the effect of the conditioning regimen had disappeared. In addition, some of these responses were associated with an increase in the serum anticarcinoembryonic antigen antibody level.
  
  
  CONCLUSIONS
  Pancreatic cancer appeared to be sensitive to a graft-versus-tumor effect; therefore, a larger clinical study with a refined strategy is warranted.
authors.affiliation: Department of Cell Therapy & Transplantation Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. ycand-tky@umin.ac.jp
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Masaaki
authors.initials: M
authors.lastname: Akahane
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kojima
authors.forename: Yuki
authors.initials: Y
authors.lastname: Asano-Mori
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Kumi
authors.initials: K
authors.lastname: Oshima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Seishi
authors.initials: S
authors.lastname: Ogawa
authors.forename: Toru
authors.initials: T
authors.lastname: Motokura
authors.forename: Shigeru
authors.initials: S
authors.lastname: Chiba
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Hisamaru
authors.initials: H
authors.lastname: Hirai
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000276:immunology; D002272:Carcinoembryonic Antigen / Q000276:immunology / Q000378:metabolism; D005260:Female; D020350:Graft vs Tumor Effect / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000276:immunology* / Q000601:surgery / Q000628:therapy*; D033581:Stem Cell Transplantation; D015996:Survival Rate; D015898:Tomography Scanners, X-Ray Computed; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D002272:Carcinoembryonic Antigen