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研究发现转移型乳腺癌的免疫疗法
美国国家癌症研究中心的研究人员发现了免疫细胞移植疗法可以使乳腺癌转移患者的肿瘤缩小。类似的，移植的免疫细胞对于白血病和淋巴癌都有显著的抗肿瘤效果。此前的研究没有证明这种疗法对乳腺癌有临床疗效。
这项研究发表在八月16号的Journal of Clinical Oncology网站上。
Scientists at the Experimental Transplantation and Immunology Branch of NCI’s Center for Cancer Research studied 16 women with breast cancer that had progressed to an average of three metastatic sites after conventional treatments, including chemotherapy and hormones; six of these had tumor shrinkage after cellular immune therapy.
Bishop’s group gave study patients a treatment similar to a bone marrow transplant. Each patient received cells donated by a sibling. This transplant included lymphocytes — cells crucial to the immune system — and the adult stem cells that produce blood cells. The active, anti-tumor component of this cellular immune therapy regimen was a class of lymphocytes called T-cells, which attack and kill tumor cells.
The same qualities that make transplanted T-cells react against tumors — especially their pugnacious tendency to attack foreign cells — also make them dangerous to the transplant recipient. Because the recipient’s own immune system may attack donor cells, NCI scientists gave subjects an immune-suppressing chemotherapy regimen before the transplant. To help protect subjects’ bodies from the toxic effects of the transplant, scientists followed the chemotherapy with a course of transplant-conditioning drugs.
Each subject received transplants with the same concentration of T-cells. The initial transplants had a relatively low concentration of these cells; infusions given at 42, 70, and 98 days after the first transplant had exponentially increasing numbers of T-cells. Increasing the concentration over this time period helped NCI researchers isolate patients’ reactions to the transplant from their reaction to the chemotherapy and established T-cells as the active element in the transplant.
Six patients of the 16 had partial or minor responses to the treatment lasting an average of three months. The transplants had a toxic effect in many of the women, having not only anti-tumor activity but also attacking normal cells. This graft-versus-host disease (GVHD) was observed in a majority of subjects: ten had acute GVHD; of thirteen available for a follow-up examination, four had chronic GVHD.
“Although it was hoped that the women would garner clinical benefit from this research, the study was not designed to demonstrate that this immune cell therapy results in an improvement of outcome, specifically survival,” Bishop explained.
“The study demonstrated that immune based therapies, specifically the lymphocyte-based therapy we used, could result in tumor regression,” Bishop said. However, it is crucial to improve cellular immune therapy by lowering the risk of toxic effects, especially GVHD. Collaborating laboratories are currently testing specialized T-cells they hope will cause little GVHD while retaining strong anti-tumor effects.
“These data provide support to continue efforts to develop better immune-based therapies to augment currently available therapies for metastatic breast cancer,” which is critical since current chemotherapies for the disease result in an average survival of only 24 months [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-01-23 17:14
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