6533b7d1fe1ef96bd125c398
RESEARCH PRODUCT
First results for resetting the antitumor immune response by immune corrective surgery in colon cancer.
Emilio Barbera-guillemM. Bud NelsonMark ArnoldEdward W. MartinEdward W. Martinsubject
Oncologymedicine.medical_specialtyColorectal cancerAntibodies NeoplasmImmune systemAntigenAntigens NeoplasmInternal medicineCarcinomamedicineHumansProspective StudiesLymph nodeNeoplasm StagingAntigen PresentationbiologyFollicular dendritic cellsbusiness.industryGeneral Medicinemedicine.diseasePrognosisSurvival Analysismedicine.anatomical_structureTreatment OutcomeRadioimmunodetectionImmunologyAntibody FormationColonic Neoplasmsbiology.proteinLymph Node ExcisionSurgeryLymphImmunotherapyLymph NodesAntibodyNeoplasm Recurrence Localbusinessdescription
BACKGROUND: A critical step for cancer recurrence is the failure of the cellular immune response. It is suspected that chronic humoral immune responses against some tumor-associated antigens (TAA) can contribute to that failure. METHODS: In this study, we tested the ability of an immune corrective surgical procedure to prevent recurrences of colon cancer in stages I, II, and III. Radiolabeled anti-TAG antibodies injected intravenously become concentrated on TAG-72 immune complexes presented by follicular dendritic cells, which are responsible for the persistent humoral response against TAG-72 TAA. Using a hand-held gamma probe, we can intraoperatively detect and remove lymph nodes involved in TAG-72 presentation. By removing these lymph nodes, together with the tumor tissue, presentation and source of TAG-72 are drastically reduced. RESULTS: The impact of this TAA suppression on the tumor recurrence process is analyzed in a sample of 24 patients. The immune corrective surgical procedure did not increase morbidity. Five years after surgery the following were disease free: 5 of 5 stage I, 6 of 6 stage II, and 10 of 13 stage III. The global survival of this group was 87.5%. Compared with the standard surgical treatment of colon cancer (58% survival for the same stages), this surgical immune corrective procedure introduces a statistically significant improvement of 29% (P <0.001). CONCLUSIONS: The surgical removal of lymph nodes involved in the persistent humoral immune response against TAA has an important beneficial impact on colon cancer treatment.
year | journal | country | edition | language |
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1998-11-17 | American journal of surgery |