8883420

pubmed:Citation

8

Studies in animal models of mouse mammary carcinoma have shown that ovine submaxillary mucin, which carries multiple sialyl-Tn (STn) epitopes, is effective in stimulating an immune response and inhibiting tumour growth. In similar studies using carbohydrate antigens, pretreatment with low-dose cyclophosphamide has been shown to be important in modulating the immune response to antigen possibly by inhibiting suppresser T-cell activity. In a clinical trial assessing the efficacy and toxicity of synthetic STn, patients with metastatic breast cancer were randomised to receive 100 micrograms STn linked to keyhole limpet haemocyanin (KLH) with DETOX-B adjuvant given by subcutaneous injection at weeks 0, 2, 5 and 9 with or without low-dose cyclophosphamide (CTX, 300 mg m-2) pretreatment, 3 days before the start of immunotherapy. Patients with responding or stable disease after the first four injections were eligible to receive STn-KLH at 4 week intervals. The main toxicity noted was the development of subcutaneous granulomata at injection sites. Of 23 patients randomised, 18 received four injections, 5 patients having developed progressive disease during the initial 12 week period. Two minor responses were noted in the 18 patients who received four active specific immunotherapy (ASI) injections and a further five patients had stable disease. Six patients continued ASI at 4 week intervals and a partial response was noted in a patient who had previously had stable disease. All patients developed IgG and IgM responses to sialyl-Tn and levels of IgM antibodies were significantly higher in those patients who were pretreated with CTX. Measurable tumour responses have been recorded following ASI with STn-KLH plus DETOX and the immunomodulatory properties of low-dose CTX have been confirmed.

eng

IM

MEDLINE

0007-0920

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NLM

1292-6

pubmed-meshheading:8883420-Adjuvants, Immunologic, pubmed-meshheading:8883420-Adult, pubmed-meshheading:8883420-Aged, pubmed-meshheading:8883420-Antibodies, Neoplasm, pubmed-meshheading:8883420-Antigens, Tumor-Associated, Carbohydrate, pubmed-meshheading:8883420-Breast Neoplasms, pubmed-meshheading:8883420-Chemotherapy, Adjuvant, pubmed-meshheading:8883420-Combined Modality Therapy, pubmed-meshheading:8883420-Cyclophosphamide, pubmed-meshheading:8883420-Dose-Response Relationship, Drug, pubmed-meshheading:8883420-Female, pubmed-meshheading:8883420-Hemocyanin, pubmed-meshheading:8883420-Humans, pubmed-meshheading:8883420-Immunoconjugates, pubmed-meshheading:8883420-Immunoglobulin G, pubmed-meshheading:8883420-Immunoglobulin M, pubmed-meshheading:8883420-Immunotherapy, Active, pubmed-meshheading:8883420-Middle Aged, pubmed-meshheading:8883420-Sensitivity and Specificity

A randomised phase II study of sialyl-Tn and DETOX-B adjuvant with or without cyclophosphamide pretreatment for the active specific immunotherapy of breast cancer.

Journal Article, Clinical Trial, Randomized Controlled Trial, Clinical Trial, Phase II