FIRST RESULTS FOR RESETTING THE ANTITUMOR IMMUNE-RESPONSE BY IMMUNE CORRECTIVE SURGERY IN COLON-CANCER

BACKGROUND: A critical step for cancer recurrence is the failure of th e cellular immune response. It is suspected that chronic humoral immun e responses against some tumor-associated antigens (TAA) can contribut e 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 inje cted intravenously become concentrated on TAG-72 immune complexes pres ented by follicular dendritic cells, which are responsible for the per sistent humoral response against TAG-72 TAA. Using a hand-held gamma p robe, we can intraoperatively detect and remove lymph nodes involved i n TAG-72 presentation. By removing these lymph nodes, together with th e tumor tissue, presentation and source of TAG-72 are drastically redu ced. RESULTS: The impact of this TAA suppression on the tumor recurren ce process is analyzed in a sample of 24 patients. The immune correcti ve surgical procedure did not increase morbidity. Five years after sur gery 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% sur vival 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 persi stent humoral immune response against TAA has an important beneficial impact on colon cancer treatment. (C) 1998 by Excerpta Medica, Inc.