Importance of Systemic Primary Active Chemotherapy, Tumor Marker in Complete Remission of Choriocarcinoma, and their Application in its Prevention

2018 ◽  
Vol 07 (01) ◽  
Author(s):  
Kazuo Maeda
Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 16-16 ◽  
Author(s):  
Zwi N. Berneman ◽  
Ann an de Velde ◽  
Sébastien Anguille ◽  
Nathalie Cools ◽  
Ann Van Driessche ◽  
...  

Abstract Abstract 16 Immunization using tumor antigen-loaded dendritic cells (DC) holds promise for the adjuvant treatment of cancer to control residual disease. In a phase I/II trial, we investigated the effect of autologous DC vaccination in 17 patients with acute myeloid leukemia (AML) in remission but at high risk of full relapse. Wilms’ tumor 1 protein (WT1), a nearly universal tumor antigen, was chosen as an immunotherapeutic target because of its established role in leukemogenesis and superior immunogenic characteristics. Two out of 3 patients, who were in partial remission with morphologically demonstrable disease after chemotherapy, were brought into complete remission following 4 biweekly intradermal injections of WT1 mRNA-electroporated DC. In those 2 patients as well as in 7 other patients who were in complete remission but who had molecularly demonstrable residual disease, there was a return to normal of the AML-associated WT1 mRNA tumor marker following DC vaccination, compatible with clinical and molecular response in 9/17 patients. In 3 patients, the WT1 mRNA tumor marker returned to pathological values following normalization after initial DC vaccination and additional injections of DC were needed to bring back the tumor marker to normal. Of the 9 responders, 3 have relapsed and 2 have died. Of the 8 non-responders, 7 have relapsed and 7 have died. Of the 2 patients in partial remission who were brought into complete remission by the DC vaccination, 1 has relapsed and has died. Median overall survival was 52.0 months in responders as compared to 6.0 months in non-responders (P=0.0007). Median relapse-free survival was 47.0 months in responders and 3.0 months in non-responders (P smaller than 0.0001). Immunomonitoring performed on the first 10 patients, showed a significant increase in WT1-specific interferon-gamma+ CD8+ T cells and signs of general immune stimulation, such as a significant increase of plasma levels of interleukin 2 and of HLA-DR+ CD4+ T-cells. Clinical responses were correlated with elevated levels of activated natural killer cells post-vaccination. Long-term clinical responses, lasting for at least 3 years, were significantly correlated with an increase in polyepitope WT1-specific tetramer+ CD8+ T-cell frequencies. There was no significant change post-vaccination in WT1 antibody levels or of regulatory T lymphocytes. In conclusion, DC-based immunotherapy elicits both innate and adaptive cellular immune responses correlated with clinical benefit. WT1 mRNA-loaded DC emerge as a feasible and effective strategy to control residual disease in AML, in particular as a post-remission treatment to prevent full relapse. Disclosures: Berneman: Argos Therapeutics: Patents & Royalties. Van Tendeloo:Argos Therapeutics: Patents & Royalties.


1995 ◽  
Vol 10 (3) ◽  
pp. 174-179 ◽  
Author(s):  
J.J. B. López Sáez ◽  
A. Senra-Varela

The objective of this study is the evaluation of serum levels of lipid-bound sialic acid (LSA) as a of marker cancer. This is a case-control study, and the levels of LSA were determined with blinded duplicates of cases and controls. Histologic verification of all cancer cases was used to confirm the diagnosis. The study included 135 patients with cancer (breast carcinoma, head and neck squamous cell carcinoma, lung cancer and gastrointestinal cancer) and 95 controls (57 normal subjects and 38 with chronic non-malignant diseases). Marker determination was done by the spectrophotometric procedure of Katopodis with resorcinol. The mean LSA level in the 57 healthy individuals was 15.09 mg/dl (95% C.I., 13.51-16.67), in the entire control group of 95 non-tumoral individuals it was 19.21 mg/dl (17.18-21.24), and in the 135 cancer patients it was 26.64 mg/dl (24.42-28.87). There was a statistically significant difference between patients with chronic non-tumoral diseases and healthy individuals (p<0.001) and also between cancer patients and healthy individuals (p<0.001), but not between cancer patients and patients with chronic non-tumoral diseases (p>0.05). The mean LSA serum values related to tumor site were (mg/dl): breast cancer, 21.49; gastrointestinal tumors, 28.45; head and neck cancer, 28.61 and lung cancer, 32.54. The means according to clinical stage were: complete remission, 18.50, significantly higher than the healthy controls (p<0.05); local disease, 23.50 (p<0.01); locoregional disease, (p<0.05); local disease, 23.50 (p < 0.01); locoregional disease, 27.21 (p < 0.001); metastatic disease, 34.49 (p < 0.001), and relapses, 20.87 (p<0.05). When comparing patients with clinically active cancer with healthy persons, the estimated cutoff value was 19.1 mg/dl, with a sensitivity of 74.7% and a specificity of 74.7%. We conclude that LSA values increase in cases of clinically active cancer and decrease in complete remission. LSA is of great value as a tumor marker in the diagnosis of disease extent.


2001 ◽  
Vol 120 (5) ◽  
pp. A299-A299
Author(s):  
D KAZANOV ◽  
B STERN ◽  
W PYERIN ◽  
O BOECHER ◽  
H STRUL ◽  
...  

1985 ◽  
Vol 24 (05) ◽  
pp. 232-237 ◽  
Author(s):  
R Klapdor ◽  
B. Kremer ◽  
B. Rothe ◽  
R Montz ◽  

ZusammenfassungAuf der Basis ermutigender Veröffentlichungen über die Immunszintigraphie bei kolorektalen Karzinomen sowie eigener immunhistochemischer und immunszintigraphischer Befunde an Pankreaskarzinom-Transplantaten auf der Nacktmaus untersuchten wir die diagnostischen Möglichkeiten mit 131J-markierten Antikörpern gegen die Tumor-Marker CA 19-9 und CEA bei 21 Patienten mit Pankreaskarzinom. Zum Vergleich dienten die Untersuchungsergebnisse von weiteren 10 Patienten mit kolorektalem Karzinom, 2 Patienten mit Gallengangs- und 1 mit Magen-Karzinom. Planare Szintigramme der Verdachtsregionen in 2-4 Sichten wurden mehrfach bis 6 Tage nach i.v. Infusion von 2 mCi eines Cocktails aus 131J-anti-CA 19-9 und -anti-CEA aufgenommen. SPECT wurde außerdem 3-4 Tage p.i., zuletzt auch früher, durchgeführt. Primäre Tumoren und Metastasen im Oberbauch waren wegen geringerer Tumor/Umgebungs-Relation der Traceraktivität schwieriger nachzuweisen und zu lokalisieren als kolorektale Karzinome im Unterbauch. Die Tumorabgrenzung wurde in planaren Szintigrammen meist erst 5-6 Tage p.i. oder später erkennbar. SPECT wies dieselben Befunde bereits 3 Tage p. i. oder früher nach. Die Lokalisation und die topographische Zuordnung gelang mit SPECT leichter und häufiger, somit der Nachweis sicherer und empfindlicher. Größere Tumoren stellten sich auch in Fällen ohne erhöhte Serumkonzentration der Tumormarker dar. Der Immunszintigraphie des Pankreaskarzinoms und anderer Karzinommanifestationen im Oberbauch kommt gegenwärtig eine eingeschränkte diagnostische Bedeutung zu; methodische Verbesserungen erscheinen notwendig und möglich.


2004 ◽  
Vol 42 (05) ◽  
Author(s):  
M Kassai ◽  
L Illényi ◽  
Ö Horváth ◽  
G Horváth ◽  
Y Al-Farhat

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