Graft-versus-tumor effect against advanced pancreatic cancer after allogeneic reduced-intensity stem cell transplantation.
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.
Kanda
Yoshinobu
Y
Department of Cell Therapy & Transplantation Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. ycand-tky@umin.ac.jp
Komatsu
Yutaka
Y
Akahane
Masaaki
M
Kojima
Shigeyuki
S
Asano-Mori
Yuki
Y
Tada
Minoru
M
Oshima
Kumi
K
Isayama
Hiroyuki
H
Ogawa
Seishi
S
Motokura
Toru
T
Chiba
Shigeru
S
Ohtomo
Kuni
K
Omata
Masao
M
Hirai
Hisamaru
H
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
D000906:Antibodies; D002272:Carcinoembryonic Antigen