NEOADJUVANT CHEMOIMMUNOTHERAPY WITH CISPLATIN AND LOW-DOSE INTERLEUKIN-2 FOR LOCALLY ADVANCED ESOPHAGEAL-CARCINOMA

After a single dose of cisplatin, the ability of peripheral blood mono nuclear cells (PBMC) to generate lymphokine-activated killer (LAK) cel ls was significantly augmented in cancer patients. Based on this clini cal finding, the patients with locally advanced esophageal carcinoma w ere thus treated with a combination of cisplatin and low-dose interleu kin-2 (IL-2) in a neoadjuvant setting. Four patients with squamous cel l carcinoma of the esophagus (T3 or T4 disease) were preoperatively tr eated with a regimen consisting of 50 mg/m(2) cisplatin on day 1, foll owed by IL-2 from day 4 through day 8, when the ability of PBMC to gen erate LAK cells had been shown to be significantly augmented. After tw o to four courses of the preoperative therapy, one patient achieved a histologic CR, one showed PR and one MR. No severe toxicity was encoun tered. All patients thereafter underwent surgery. The median survival of these patients was 47.5 months and three of the patients had been d isease free for 43 to 62 months after the initiation of the therapy. T he combination of cisplatin and low-dose IL-2 administered in a neoadj uvant setting seems to result in an improved survival of locally advan ced squamous cell carcinoma of the esophagus.