Brezicka Thomas
Department of Respiratory Medicine and Allergology, Göteborg University, Sweden.
Acta Oncol. 2005;44(7):723-7. doi: 10.1080/02841860500218561.
Small cell lung cancer (SCLC) comprises 15-20% of all lung cancer. Despite high initial response to chemotherapy chemoresistance at relapse leads to a less than 5% five-year survival rate. Adjuvant treatment with monoclonal antibodies (Mabs) against SCLC antigens may offer a therapeutic option. Mab 17-1A directed against the epithelial-cell adhesion molecule (Ep-CAM) has been extensively tested for therapy in patients with colorectal carcinoma. Expression of Ep-CAM in SCLC has been earlier described. However, reactivity of Mab 17-1A and another Ep-CAM-binding Mab BerEP4 has not yet been described for SCLC. Using immunohistology first with BerEP4 and confirmatory with 17-1A a homogenous and strong expression of Ep-CAM was seen in all SCLC specimens tested (n = 10). For comparison, heterogenous expression was seen in the non-SCLC tumors tested (n = 15). These findings strongly suggest that Mab 17-1A can be useful for adjuvant immunotherapy in patients with SCLC. For detection of Ep-CAM in tumor tissue in patients that might be considered for immunotherapy with Mab 17-1A, Mab BerEP4 appears to be preferred.
小细胞肺癌(SCLC)占所有肺癌的15%-20%。尽管初始时对化疗反应良好,但复发时的化疗耐药导致五年生存率低于5%。用针对SCLC抗原的单克隆抗体(Mab)进行辅助治疗可能提供一种治疗选择。针对上皮细胞粘附分子(Ep-CAM)的单克隆抗体17-1A已在结直肠癌患者的治疗中进行了广泛测试。Ep-CAM在SCLC中的表达此前已有描述。然而,单克隆抗体17-1A和另一种与Ep-CAM结合的单克隆抗体BerEP4在SCLC中的反应性尚未见报道。首先使用BerEP4进行免疫组织化学检测,并用17-1A进行确认,在所有测试的SCLC标本(n = 10)中均可见Ep-CAM的均匀且强表达。作为对照,在测试的非SCLC肿瘤(n = 15)中可见异质性表达。这些发现强烈表明,单克隆抗体17-1A可用于SCLC患者的辅助免疫治疗。对于可能考虑用单克隆抗体17-1A进行免疫治疗的患者,在肿瘤组织中检测Ep-CAM时,单克隆抗体BerEP4似乎更可取。