Four-year follow-up on the Albany experience with intrapleural BCG in lung cancer

Immunotherapy of Lung Cancer

“…87,88 These investigators randomized 169 patients to receive intrapleural BCG plus isoniazid or isoniazid alone. 89 The result at three years was a 62 percent recurrence rate in the control group and a 33 percent recurrence rate in the BCG treated group in patients with stage I resected disease. 89 Intrapleural BCG was not beneficial to patients with stage II or III disease.…”

“…89 The result at three years was a 62 percent recurrence rate in the control group and a 33 percent recurrence rate in the BCG treated group in patients with stage I resected disease. 89 Intrapleural BCG was not beneficial to patients with stage II or III disease. However, the fact that this study was begun before the importance of careful intraoperative staging was appreciated may account for the poor outcome in the control group.…”

“…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.…”

“…Mc-Kneally and colleagues conducted a prospective, randomized trial of intrapleural BCG. 85,[87][88][89] This trial resulted from the unintentional finding by Ruckdeschel and associates that among 472 patients who underwent pulmonary resection for lung cancer, 18 developed postoperative empyema. 109 Of these patients, nine survived five years, suggesting that microbial antigens in the lymphatic drainage field previously occupied by the tumor might stimulate some form of cross-protective immune response.…”

The Role of Adjuvant Therapy in the Surgical Treatment of Lung Cancer

“…18 A four-year followup on this study, which ultimately had thirty stage I BCG treated patients and thirty-six simultaneously randomized controls, showed the reduction in recurrences among BCG treated patients to be demonstrable, but the difference, although statistically significant, was less dramatic than it appeared initially. 19 Lowe conducted a similar trial but did not report similar findings. 16 No significant benefit from intrapleural BCG could be shown nor were any favorable trends between the groups reported.…”