V.A.Tarasov, M.V.Filatov, V.V.Stavrovietskiy, E.S.Pobegalov, K.K.Lezhnev, A.V.Koloskov, .G.Andreassian
COMBINED SURGERY WITH CONSECUTIVE IMMUNOTHERAPY
Medical Academy of Postgraduate Education,
IVth International Meeting
"Immunological Approaches to Tumor Therapy"
Abstracts Edited:
Stage IV colorectal cancer
at the moment undergoes only palliative therapy. Our experience showes that,
despite this opinion, in 80% cases of advanced colorectal cancer with distant
metastases to lungs and liver it is possible to remove surgically both the
primary tumour and the distant metastases.
53 patients underwent
extended and combined radical surgery for stage IV colorectal cancer; 45 of
them survived the early postoperative period. Considering insufficient
effectiveness of postsurgical chemotherapy, we complemented it with a 3-month
postoperative course of vaccinotherapy, using alive reproductively-inactivated
autologous tumour cells in combination with ajuvants of bacterial, viral, or
synthetic origin, aimed at activation of antitumourous cell imminity. Inductors
of interpherone (Interleukin-2 and alpha-Interpherone) were used in addition.
The results of our work
permit to consider that extended and combined radical surgery is successful in
85% patients with stage IV colorectal cancer. Combined surgery results in
significant improvement of patients’ condition, which makes it possible
to conduct effective postsurgical therapy. 60% patients were alive without
signs of recurrency1 year, and 40% - 2 years after extended and combined
surgery.
Our observations allow to
conclude that effective immunotherapy may be complicated with 2 circumstances:
·
Predominant activation of humoral immune responce may lead to the
socalled blocking effect induced by antibodies linked to the tumour, which
might result in ineffectiveness of further immunotherapy. In this case, character
of immune response needs to be corrected.
·
In some cases, autoimmune reactions may occur during vaccination, being
accompanied by marked inflammatory process. To control the latter, which is
necessary in these cases, we proposed an original, highly sensitive method to
detect inflammation of different nature, which is based upon flow
cytofluorometric registration of respiratory burst of peripheral blood
neutrofiles (M V Filatov. Biochemical and Molecular Medicine 1995; 55; 116-21).
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