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Ann Surg Oncol. 2010 Jul;17(7):1747-57. doi: 10.1245/s10434-010-0920-8. Epub 2010 Jan 30.

Pilot study of sentinel-node-based adoptive immunotherapy in advanced colorectal cancer.

Author information

1
Karolinska Institute, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.

Abstract

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.

PMID:
20119674
PMCID:
PMC2889279
DOI:
10.1245/s10434-010-0920-8
[Indexed for MEDLINE]
Free PMC Article

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