Prognostic value of prechemotherapy skin tests in patients with metastatic breast carcinoma

Abstract

Two hundred patients with metastatic breast cancer who were treated with combination chemotherapy and nonspecific immunotherapy with BCG or MER were skin tested prior to, and at regular intervals during the administration of chemotherapy with a battery of six antigens (Dermatophytin, Varidase, candida, mumps, PPD, and KLH). Delayed-type hypersensitivity responses to this battery of antigens were analyzed to assess whether they correlated with ability to respond to chemotherapy, length of survival, and a number of other host and tumor characteristics of known prognostic significance. Responsiveness to individual recall antigens or the number of positive skin test responses did not correlate with overall or complete response rates. The correlation did exist with KLH, a primary antigen. A positive response to two or more antigens correlated with a longer survival. Inability to mount a skin test response to any antigen correlated with poor survival. PPD conversions during serial BCG administration did not correlate with a better prognosis. Serial skin testing with a battery of antigens did not correlate with prognosis. Skin test responsiveness to the antigens used in this study did not correlate with the other pretreatment factors of prognostic importance such as tumor burden, absolute lymphocyte count, performance status, prior radiation therapy, menopausal status, and age. Therefore, responsiveness to skin testing with these antigens appears to be an independent prognostic variable and should be incorporated in the planning and analysis of systemic treatment programs in metastatic breast cancer.

Immune reactivity in cattle with ocular squamous cell carcinoma after intralesional BCG immunotherapy

“…Therefore, this parameter cannot be used for prognosis, which is in agreement with results reported by Hortobagyi et al [31]. Therefore, this parameter cannot be used for prognosis, which is in agreement with results reported by Hortobagyi et al [31].…”

Influences of Distress and Alcohol Consumption on the Development of a Delayed-Type Hypersensitivity Skin Test Response

“…The CMI Multitest was also administered, and the development of DTH skin test responses was measured at 48 hours in the same manner as for the DTH responses against KLH. A positive cutaneous DTH response against KLH was defined as an induration of greater than 2 mm (17). The criterion for nonresponse (anergy) on the CMI Multitest was no response of at least 2 mm (7).…”

“…DTH skin test responses against KLH can be reliably elicited in human subjects (6,15), and an appropriate immunization protocol has been developed (6). In addition, cutaneous DTH against KLH may be indicative of overall cellular immune competence since responsiveness to KLH has been shown to correlate with responsiveness to a battery of prognostic antigens (16,17).…”

Delayed cutaneous hypersensitivity, lymphocyte count, and blood tests in patients with breast carcinoma

“…In patients with recurrent breast cancers, Cunningham et a1 [7] found that patients with a strong DCH reaction to DNCB had a significantly higher probability of surviving at 52 and 78 weeks, a longer median length of survival, and a greater probability of responding to therapy. In patients with metastatic breast cancer, Hortobagyi et a1 [18] found that DCH to any of six recall antigens or the number of positive skin test responses did not correlate with overall or complete response rate to chemotherapy. This correlation did exist with KLH.…”