Toge T, Takayama T, Kegoya Y, Kuninobu H, Yamaguchi Y, Hattori T
Department of Surgery, Hiroshima University, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1455-8.
Clinical efficacy of lymphokine-activated killer (LAK) cell adoptive immunotherapy (AIT) in combination with plasma exchange was investigated as protocol 1 in 24 patients with advanced cancer. For the development of protocol 1, AIT in combination with plasma exchange, OK-432, interleukin-2 (IL-2) and cyclophosphamide was performed as protocol 2, in which LAK cells, OK-432 and IL-2 were administered through the catheter located in the hepatic or bronchial artery. The clinical efficacy of protocol 1 was found in patients with pleural effusion and metastasis to the lung or liver and resulted in 4 partial responses (20%) and 1 minor response of 20 evaluable cases. On the other hand, that of protocol 2 did 1 partial response (20%) in 5 cases. In vitro cytotoxic activity against either Daudi or K 562 tumor cells of peripheral blood lymphocytes from patient given intraaorta administration of OK-432 and IL-2 was tended to increase to be higher than that from nontreated patients. Postoperative immunodepression in esophageal cancer was blocked by AIT, suggesting the usefulness of AIT as a postoperative adjuvant immunotherapy. Thus, target organ of AIT should be limited for better therapeutic effect and the superiority of local AIT in combination with biological response modifiers may be indicated.
作为方案1，对24例晚期癌症患者研究了淋巴因子激活的杀伤（LAK）细胞过继性免疫疗法（AIT）联合血浆置换的临床疗效。为制定方案1，将AIT联合血浆置换、OK-432、白细胞介素-2（IL-2）和环磷酰胺作为方案2实施，其中通过置于肝动脉或支气管动脉的导管给予LAK细胞、OK-432和IL-2。方案1的临床疗效在有胸腔积液以及肺或肝转移的患者中得到体现，20例可评估病例中有4例部分缓解（20%）和1例轻度缓解。另一方面，方案2在5例患者中有1例部分缓解（20%）。经主动脉给予OK-432和IL-2的患者外周血淋巴细胞对Daudi或K 562肿瘤细胞的体外细胞毒性活性倾向于升高，高于未治疗患者。AIT可阻断食管癌术后免疫抑制，提示AIT作为术后辅助免疫疗法的有效性。因此，为获得更好的治疗效果，AIT的靶器官应加以限定，并且可能表明局部AIT联合生物反应调节剂具有优越性。
