Postoperative intrapleural BCG in lung cancer: lack of efficacy and possible enhancement of tumour growth.

Bakker, W.; Nijhuis-Heddes, J.M.A; Wever, A. M. J.; Rivière, Aart Brutel de la; Velde, E. A. van der; Dijkman, J. H.

doi:10.1136/thx.36.11.870

Cited by 14 publications

(6 citation statements)

References 11 publications

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“…However, the low survival rate of their control group undermines the validity of their conclusions. Other studies have failed to confirm an improvement in survival asso-elated with the use of intrapleural BCG [1,13,21,33], possibly because of the use of a different strain of BCG. More recent studies, using the same Tice BCG as McKneally et al were unable to detect any beneficial effect of intrapleural BCG [20,28,42].…”

Section: Discussionmentioning

confidence: 97%

“…The survival data of the group of patients studiedwere compared with those of an historical control group. The early results of this comparison did not suggest any beneficial effect attributable to BCG [1]. This report presents the 5-year follow-up of these survival data.…”

mentioning

confidence: 82%

“…Although a detailed description of the study design can be found elsewhere [1,2] a brief outline will be given.…”

Section: Methodsmentioning

confidence: 99%

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Post-operative intrapleural BCG in lung cancer: A 5-year follow-up report

Bakker

Nijhuis-Heddes

Velde

1986

Cancer Immunol Immunother

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Of a total study group of 99 patients 56 received intrapleural BCG in three different dosages (5 patients 16 X 10(6), 25 patients 32 X 10(6), and 26 patients 64 X 10(6) culturable particles) following resection treatment for lung cancer. This study group was compared with an historical control population, very closely matched with regard to age, sex, stage of disease, histology and type of operation. Although the clinical condition of the patients selected for BCG treatment was above average, no survival benefit ensued from the intrapleural BCG. On the contrary, disease-free survival in BCG receivers with stage I and II squamous cell carcinoma was shortened significantly at 2 years follow-up due to the earlier appearance of local recurrences, with the same tendency still present after 5 years. This observation suggests an enhancement of tumour growth by the intrapleural BCG treatment. This alarming phenomenon could be a warning to clinicians when planning clinical immunotherapy trials to be aware of the potentially deleterious effects of such treatment.

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 82%

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Post-operative intrapleural BCG in lung cancer: A 5-year follow-up report

Bakker

Nijhuis-Heddes

Velde

1986

Cancer Immunol Immunother

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“…42 The clinical analogy would be the use of allogeneic (homologous) versus autologous transfusions. 49,50 Also, immune responses to human tumors were rarely demonstrable. Similar observations were made for most other surgically treatable tumors, although about one third of the studies did not achieve statistical significance despite uniformly poorer outcomes in the transfused patients.…”

Section: Transfusion and Cancer Recurrencementioning

confidence: 99%

Transfusion-Related Immunomodulation

Blumberg¹,

Heal²

2007

Blood Banking and Transfusion Medicine

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“…Based upon these encouraging results, several larger randomized trials were undertaken. Unfortunately, none of these trials demonstrated a survival advantage of adjuvant IP BCG compared to controls [9,10]. Based on the results of these studies, further investigations into IP BCG as adjuvant therapy for lung cancer were not pursued; however, the concept of using the pleural space as a site of delivery of novel therapeutics to treat primary or metastatic pleural malignancies has remained.…”

Section: Introductionmentioning

confidence: 99%

Novel Intrapleural Therapies for Malignant Diseases

Haas¹,

Sterman²

2012

Respiration

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Pleural malignancies, either primary or metastatic, are common and problematic clinical issues in thoracic oncology and pulmonary medicine. Malignant pleural mesothelioma and metastatic pleural effusions often present late in the course of a disease and have a dramatic impact on the patient’s quality of life and survival. Novel approaches to manage mesothelioma and malignant pleural effusions are desperately needed and the pleural space provides a unique platform as an easily accessible body cavity for developing and assessing these treatments and their responses. In this review, we discuss the unique intrapleural chemotherapeutic, immunotherapeutic and genetic treatments that have been investigated, as well as those under current clinical development. While responses have been demonstrated to variable degrees with all these approaches, an integrated multimodality approach incorporating these methods with other anti-neoplastic interventions ultimately will ensure the best responses and patient outcomes.

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Postoperative intrapleural BCG in lung cancer: lack of efficacy and possible enhancement of tumour growth.

Cited by 14 publications

References 11 publications

Post-operative intrapleural BCG in lung cancer: A 5-year follow-up report

Post-operative intrapleural BCG in lung cancer: A 5-year follow-up report

Transfusion-Related Immunomodulation

Novel Intrapleural Therapies for Malignant Diseases

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