Adjuvant immunotherapy with BCG in squamous-cell bronchial carcinoma. Immune-reactivity in relation to immunostimulation (preliminary results in a controlled trial)

Abstract

(1978). Thorax, 33,[429][430][431][432][433][434][435][436][437][438] Adjuvant immunotherapy with BCG in squamous-cell bronchial carcinoma. Immune-reactivity in relation to immunostimulation (preliminary results in a controlled trial). Twenty-nine patients with, at operation, evidence of locally advanced primary squamous-cell bronchial carcinoma (stage II, UICC, Geneva, 1974) had lung resection to remove all the visible tumour. Postoperatively a randomly chosen group of 16 patients received adjuvant BCG immunostimulation by scarifications, while the control group received no adjuvant treatment. Follow-up studies were done from three to 23 months. Immune-reactivity in vivo with PPD and DNCB skin tests, and in vitro with E-rosetting tests and lymphocyte transformation tests with PHA, Con A, diphtheria toxoid, and PPD was monitored in 10 treated and in seven untreated patients. Recurrence rates decreased appreciably in the BCG-stimulated group after a six to 23 months' follow-up (p< 005). A pronounced increase in both in-vivo and in-vitro immune-reactivity went in parallel with a more favourable clinical outcome in the BCG-treated group. In these cases there was a significant increase in skin reactivity to PPD three months after surgery (p <0-025) and a statistically significant rise in lymphocyte reactivity to Con A (p< 05), diphtheria toxoid ( p<001), and PPD (p<0 05) but not to PHA 12 months after surgery. DNCB skin reactivity increased as well in the BCG-treated group, but the number of individuals was too small for statistical evaluation. Increase in immune responsiveness did not occur in the control group and appeared to be independent of the initial immune state of the patients. No differences were found in the numbers of E-rosetting lymphocytes in relation to immunotherapy. It is concluded that adjuvant BCG immunotherapy used in patients with minimal residual bronchial carcinoma improves the prognosis and a favourable clinical outcome is mirrored by an increase in cellular immune reactivity.

Adjuvant immunotherapy with BCG in squamous cell bronchial carcinoma.

“…4 A statistically significant prolongation of the re- (8 3) clinical outcome currence-free period after surgery was shown in the BCG-treated groups compared with the nonimmunotherapy group. In addition, in the individuals who were initially treated with intrapleural BCG, the same improvement of prognosis was found.…”

“…10 11 Lung resections, randomisation after operation, and follow-up were performed as described previously. 4 The observation time of the patients ranged from three to 51 months after operation. After patient 20 entered the control group, no more controls were added and the next patients were all treated.…”

Immunotherapy of Lung Cancer

“…26 Jansen and associates studied the effects of BCG scarification and scarification plus intrapleural BCG and were unable to demonstrate any difference between systemic and combined systemic and intrapleural treatment. 63,64 In both groups who had squamous cell carcinoma treated with BCG, recurrence rates decreased significantly during follow-up. Favorable clinical outcome was accompanied by an increased cellular immune reactivity.…”

“…The most widely investigated immunotherapeutic agents in lung cancer are BCG 49,53,54 and cell-wall fractions of BCG. 43,84,119 These agents have been given by aerosol, 24 intradermally, 1,26,27,38,40,60,63,64,83,102,104,108,115 intrapleurally, 64,74,75,[86][87][88][89]107,131 and intratumorally. 43,[56][57][58]82,91 AEROSOLIZED BCG.…”

Lung Cancer: A Classic Example of Tumor Escape and Progression While Providing Opportunities for Immunological Intervention

“…This induced inflammation not only kills the tumor, probably by activating the innate immune system, but also leads to sustained immune responses by activating the local antigen-presenting cells. BCG was tried to treat lung cancer but failed to show any responses [ 165 – 167 ]. Two other therapies such as using Corynebacterium parvum [ 168 ] and Mycobacterium vaccae [ 169 ] have been tried with lung cancers.…”