title: Low-dose interleukin-2 administered pre-operatively to patients with gastric cancer activates peripheral and peritumoral lymphocytes but does not affect prognosis.
abstract: BACKGROUND
  There is evidence that cancer is immunogenic under certain situations. IL-2 is described to stimulate an effective antitumor immune response in vitro and in vivo. The ability of cancer patients to undergo surgical resection is still the most important prognostic factor for many solid tumors, including gastric adenocarcinoma. The host immune system may be further compromised by surgical procedures leading to a generalized state of immunodepression in the post-operative period. The aim of this randomized case-control study is to evaluate the effects of pre-operative low-dose IL-2 treatment on patients with gastric adenocarcinoma who undergo surgery.
  
  
  METHODS
  Sixty-eight patients with gastric adenocarcinoma were enrolled in the study and randomized in two groups: 36 patients were pre-treated with IL-2 and 32 underwent surgery without any treatment. Total peripheral WBC, neutrophils, CD3(+) T, CD4(+) T, CD8(+) T and NK cells were obtained before and after surgery, at different times. Peritumoral infiltration was analyzed on all surgical specimens. Overall survival and relapse-free survival were studied with a median follow-up of 51 months.
  
  
  RESULTS
  Low-dose IL-2 treatment resulted in an increase peritumoral lymphocytic and eosinophilic infiltrations and in a minor decrease in CD3(+) T and CD4(+) T cells after surgery (P < 0.05). A stepwise multivariate analysis revealed that overall survival and relapse-free survival were affected only by stage of tumor and age of patients.
  
  
  CONCLUSIONS
  According to our data low-doses of IL-2 administered pre-operatively to patients with gastric cancer activate peripheral and peri-tumoral lymphocytes but did not affect prognosis.
authors.affiliation: Department of General Surgery, University of Milano-Bicocca, S. Gerardo Hospital, via Donizzetti 106, Monza, 20052 Milan, Italy. giovanni.cesana@gmail.com
authors.forename: Giovanni Carlo
authors.initials: GC
authors.lastname: Cesana
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Romano
authors.forename: Gaia
authors.initials: G
authors.lastname: Piacentini
authors.forename: Marco
authors.initials: M
authors.lastname: Scotti
authors.forename: Ambrogio
authors.initials: A
authors.lastname: Brenna
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bovo
authors.forename: Massimo
authors.initials: M
authors.lastname: Vaghi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Aletti
authors.forename: Roberto
authors.initials: R
authors.lastname: Caprotti
authors.forename: Howard
authors.initials: H
authors.lastname: Kaufman
authors.forename: Franco
authors.initials: F
authors.lastname: Uggeri
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000276:immunology*; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007167:Immunotherapy; D007376:Interleukin-2 / Q000008:administration & dosage*; D007694:Killer Cells, Natural / Q000276:immunology; D008213:Lymphocyte Activation / Q000502:physiology*; D018655:Lymphocyte Count; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008297:Male; D020360:Neoadjuvant Therapy; D011300:Preoperative Care; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D000970:Antineoplastic Agents; D007376:Interleukin-2