Lymphatic metastasis is common in advanced-stage carcinoma and is associated with a poor prognosis. However, few effective treatments to inhibit it are available. Z-100 is an immunomodulatory extract of Mycobacterium tuberculosis strain Aoyama B that contains polysaccharides such as arabinomannan and mannan. Here, we investigated the inhibitory effect of Z-100 on spontaneous lymphatic metastasis. C57BL/6N mice injected subcutaneously with B16-BL6 melanoma cells in the right hind footpad were administered Z-100 subcutaneously in the right inguinal region on a daily basis. On day twenty-one after the injection, the right inguinal lymph nodes were excised, and the extent of metastasis, the number of immune cells, and the amount of granzyme B protein in the lymph nodes were examined. We also investigated the combined effect of Z-100 and irradiation in this model. Results showed that Z-100 reduced number of animals with metastasis, with respective metastasis rates of 85.7%, 42.9%, 7.1% and 0.0% in saline, 0.1 mg/kg Z-100, 1 mg/kg Z-100 and 10 mg/kg Z-100 group. Further, mice that had been given Z-100 were found to have more immune cells and granzyme B protein in the lymph nodes than control mice. The combination of low dose Z-100 and irradiation also inhibited spontaneous lymph node metastases. These findings suggest that Z-100 may be beneficial in preventing lymphatic metastasis by enhancing the immune response.Key words lymph node metastasis; B16-BL6 melanoma cell; non-specific immunotherapy; radiation Metastasis is the main cause of death in advanced-stage cancer patients and occurs through three major routes: hematogenous, lymphogenous, and transcoelomic spread.1,2) Lymphatic metastasis in particular is common in advanced-stage carcinoma and is generally associated with a poor prognosis. Although the influence of lymphatic metastasis on prognosis is thoroughly understood, effective treatments to inhibit it remain lacking. 3,4) Lymph node dissection is frequently performed to treat or prevent (or both) lymph node metastasis in several types of cancer. These procedures are limited to early-stage cancer patients, however, and their efficacy has been questioned. 5,6) Chemotherapy and lymphangiogenesis inhibitors are administered in lieu of surgery to inhibit lymphatic metastasis, [7][8][9] but these drugs have limited efficacy due to their toxicity and poor bioavailability. Specifically, conventional chemotherapy cannot be delivered to the lymphatic system effectively without dose-limiting toxicity, requiring drug delivery systems such as a liposome-based delivery system. 9,10) Therefore, novel therapeutics are needed for the use in treating cancer patients with lymphatic metastasis.Immunotherapeutic approaches have been shown to inhibit lymphatic metastasis in animal models, indicating the potential of immunotherapy as treatment for lymphatic metastasis in humans.11-13) Z-100 is a hot-water extract of Mycobacterium tuberculosis strain Aoyama B and contains polysaccharides such as arabinomannan and mannan.14) Z-100 h...