Use of BCG as an immunostimulant in the surgical treatment of carcinoma of the lung

Abstract

-658. Use of BCG as an immunostimulant in the surgical treatment of carcinoma of the lung. Cell-mediated immunity to cancer cells would appear to exert some control over the extension of tumour growth, and stimulation of this factor might result in increased survival after surgical treatment of the tumour. Of the various agents used as stimulators in experimental work, BCG would seem to be the most convenient to use in man. A single dose of BCG-Glaxo (500,000 organisms) was given subdermally 10 days after excision of lung carcinoma. The length of survival was used as the index of the effect of the BCG.Two trials were initiated, the first to study the safety of BCG and a survival study of 120 consecutive cases (60 used as controls). This is an interim report at two years of this trial. The main features at this stage show that the overall survival rate has increased from 38% in the controls to 52% in the BCG group. In the squamous-cell group survival has risen from 50% to 62% and, in those with positive nodes, from 33% to 53%. In the oat-cell group, two-year survival has risen from 11% in the controls to 50% in the BCG groups, though the numbers are small. Although encouraging, the results are not statistically significant.The second trial is a randomized trial in which five surgeons have taken part, and 500 consecutive cases of lung resection for carcinoma are documented (250 control and 250 BCG). It is too early for results to be assessed in this group.

A controlled trial of BCG immunotherapy in bronchogenic carcinoma treated by surgical resection

“…A recent study (McKneally et al, 1977) has shown a statistic, ally significant increase in survival rate at 1 year in Stage I tumours following the single intrapleural injection of BCG -Tice in a dose of 107 viable units. However, Edwards and Whitwell (1974) found no statistically significant increase in survival at a year following the single subdermal injection of BCG -Glaxo in a dose of 0.5 x 106 viable units.…”

BCG treatment of malignant pleural effusions in the rat

“…It is not clear, however, whether this effect really depends upon regional application of the vaccine, since beneficial effects have also been observed in lung cancer following administration of BCG at distant intra-dermal sites (Pines, 1976;Edwards and Whitwell, 1974). However, Yamamoto et al (1975) have shown, in the guinea-pig, that a delayed hypersensitivity reaction in the pleural cavity, in response to intrapleurally injected PPD, does produce histological changes in lung tissue as well as in the pleural space.…”

Immunotherapy of lung cancer with Corynebacterium parvum

“…There have been several trials of various types of immunotherapy in lung cancer [1,5,7,14,17,19,20]. One of the immunotherapeutic agents reported to be useful in disseminated lung cancer is Corynebacterium parvum [14].…”