title: [Combination immunotherapy using autologous tumor-stimulated lymphocytes and trastuzumab (Herceptin) for the patients with recurrent breast cancer].
abstract: OBJECTIVE
  We report two patients with refractory recurrent breast cancer (HER2/neu: +) postoperatively, who had failed response to the available conventional chemotherapy of CAF (cyclophosphamide, adriamycin, 5-fluorouracil) and docetaxel, etc. They markedly responded to the combination immunotherapy using intraperitumoral injections of autologous tumor cell-stimulated T lymphocyte (AuTL) and trastuzumab (Herceptin), an anti-HER2 monoclonal antibody.
  
  
  METHODS
  AuTLs were administrated directly into the recurrent tumor by intraperitumoral injections biweekly and trastuzumab was infused systemically every week. The treatments were repeated for 6 and 11 injections in the patients, respectively. The total administered T cells had reached to 3.8 x 10(9) and 6.4 x 10(9), respectively. The dosage of trastuzumab was 2 mg/kg in each patient.
  
  
  RESULTS
  The carcinomatous pleural effusion had disappeared and was well controlled in patient 1 and a marked regression in injected fields in comparison to the size of the recurrent tumor before treatment was observed in patient 2. The tumor marker proteins (CEA, CA15-3, TPA) had also decreased significantly. The adverse effects of the immunotherapy were tolerable with grades 1-2 infusion reaction of fever, tachycardia and hypotension, but no cardiac dysfunction was observed.
  
  
  CONCLUSIONS
  Clinical responses of recurrent breast cancer were observed in two patients after receiving the intra-peritumoral AuTL injection plus trastuzumab immunotherapy. These results showed that refractory recurrent breast cancer may be controlled effectively and safely by repeating the cellular immunotherapy combined with trastuzumab and suggested utility of combining these agents in clinical trial.
authors.affiliation: Dept. of Surgery, Kurume University School of Medicine.
authors.forename: Uhi
authors.initials: U
authors.lastname: Toh
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Fujii
authors.forename: Keisuke
authors.initials: K
authors.lastname: Miwa
authors.forename: Goro
authors.initials: G
authors.lastname: Yokoyama
authors.forename: Miki
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kawamura
authors.forename: Eichirou
authors.initials: E
authors.lastname: Machida
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yamana
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D001943:Breast Neoplasms / Q000276:immunology / Q000628:therapy*; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D013601:T-Lymphocytes / Q000276:immunology* / Q000637:transplantation*; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000068878:Trastuzumab