Autologous heterotopic transplant of peripheral blood associated to chemotherapy as immunotherapy of solid tumors.

Abstract

Listen

Translate article

e13105 Background: Successive developed configurations of Autologous Heterotopic Transplant of Peripheral Blood (AHTOPB) were reported lately. In advanced stages of different primary tumors, AHTOPB has improved the antitumoral effect of chemotherapy (CH). A cohort of patients (pts) was selected from these trials to explore the biological response modifications (angiogenesis, immunity) associated to such antitumoral effect. Methods: From 6 reported 2-arm trials (CH and AHTOPB+CH treated), 60 pts were selected, 5 from each arm and trial. Trials referred to Breast, NSC Lung, prostate, ovary, pancreas, colon. Inclusion criteria: histology confirmed, M1 stage, unresectable, measurable according Response Evaluation Criteria in Solid Tumors (RECIST), PS 0-2 according Eastern Cooperative Oncology Group (ECOG), not previous CH, organic functions preserved. Exclusion criteria: brain M1, treated comorbility, additional antitumor treatment. AHTOPB procedure as it was described: 1) Cyclophosphamide low dose, 2) Immunization site conditioning with activated autologous blood, 3) Immunization with tumor antigens released to the blood inside heat shock proteins. CH: standard first line recommended for each tumor. Assessments. In venous blood sample pre/post treatment: T-Regulatory cells (T-Reg); Activated Dendritic cells (aDC); Lymphocyte Proliferative Index AHTOPB challenged (LPI); Angiostatin (AT); Interleukine-2 (IL2); Interleukine-12 (IL12); Gamma Interferon (G-If). In sentinel lymph-node of immunization site post AHTOPB treatment: T-Reg and aDC. In clinical follow up: 30-day Tumor Growth (TG) according RECIST; Disease control rate (DCR), Overall Survival (OS), Toxicities (Tx) according NCI (≥3). Measurements were expressed as % of pretreatment mean value in same primary tumor; % of 2 treatments were statistically compared using two tailed Student T-test. Results: Arm AHTOPB+CH, comparable to arm CH, evidenced significant decrease T-Reg, VEGF, TG, and increase aDC, LPI, AT, IL2, IL12, G-If, DCR. No significant different toxicity. Conclusions: In cancer pts, ATHOPB+CH elicits the conditioning to produce biological responses compatible with antitumor immunotherapy.