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Pilot Study of Sentinel-Node-Based Adoptive Immunotherapy in Advanced Colorectal Cancer.

Artikel i vetenskaplig tidskrift
Författare Mona Karlsson
Per Marits
Kjell Dahl
Tobias Dagöö
Sven Enerbäck
Magnus Thörn
Ola Winqvist
Publicerad i Annals of surgical oncology
Volym 17
Nummer/häfte 7
Sidor 1747-1757
ISSN 1534-4681
Publiceringsår 2010
Publicerad vid Institutionen för biomedicin
Sidor 1747-1757
Språk en
Länkar dx.doi.org/10.1245/s10434-010-0920-...
Ämneskategorier Mikrobiologi inom det medicinska området

Sammanfattning

BACKGROUND: Despite optimal surgical treatment and modern adjuvant therapies, 50% of patients diagnosed with colorectal cancer die within 5 years. Immunotherapy offers an appealing complement to traditional chemotherapy, with possible long-term protection against tumor recurrences through immunological memory. We have conducted a pilot study of a novel adoptive immunotherapy, using autologous, in vitro expanded lymphocytes isolated from the tumor-draining sentinel lymph node. STUDY DESIGN: Sentinel nodes were recovered from 16 patients with disseminated or locally advanced, high-risk colorectal cancer. Single-cell suspensions of sentinel-node-acquired lymphocytes were clonally expanded in vitro in the presence of autologous tumor extract and returned as a transfusion. Patients were followed with clinical and radiological evaluations. Long-term survival was compared with traditionally treated controls. RESULTS: Sentinel-node-acquired CD4(+) Th1-lymphocytes could be clonally expanded in vitro and safely administered to all 16 patients without side-effects. In four out of nine stage IV patients, complete tumor regression occurred. Median survival time in the stage IV patients (n = 9) was 2.6 years, as compared with 0.8 years in conventionally treated controls. A dose-dependent effect with regards to reduced tumor burden and long-term survival was observed. CONCLUSION: Sentinel-node-based adoptive immunotherapy is feasible; the method has shown no apparent side-effects and appears to convey therapeutic antitumor effects. Further studies are justified to determine its efficacy and precise role in the treatment of colorectal cancer.

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