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Innate immune therapy with a Bacillus Calmette-Guérin cell wall skeleton after radical surgery for non-small cell lung cancer: A case-control study

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Abstract

Purpose

We investigated whether adjuvant immunotherapy with Bacillus Calmette-Guérin (BCG) cell wall skeleton (CWS) and surgical resection was better than resection, with or without other adjuvant therapy, for patients with non-small cell lung cancer (NSCLC).

Methods

The case group comprised 71 patients who underwent radical surgery for NSCLC, followed by BCG-CWS immunotherapy, with follow-up data available. The case-control study was designed with one control selected for each case-group patient. Each control was matched by pathological stage and year of birth (±5 years). BCG-CWS 200 μg was inoculated intracutaneously in the upper arm four times per week (sensitization phase); then at 4-week intervals (therapeutic phase).

Results

The case-group patients received 45 ± 22.6 (average ± SD) cycles of BCG-CWS inoculation. Overall 5-year and 10-year survival rates were 71% and 61% for the case-group patients, and 63% and 43% for the control-group patients. The survival rate of the case group was better than that of the control group (not significant; P = 0.114). The same trend was seen in the patients with stage III or N+ NSCLC (not significant; P = 0.114, P = 0.168). There were no life-threatening adverse events.

Conclusions

BCG-CWS immunotherapy seemed to improve survival after resection of NSCLC, especially locally advanced NSCLC. Moreover, this immunotherapy did not compromise quality of life during treatment.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan

    Ken Kodama, Masahiko Higashiyama, Koji Takami, Kazuyuki Oda, Jiro Okami & Jun Maeda

  2. Department of Immunology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan

    Takashi Akazawa

  3. Department of Microbiology and Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Misako Matsumoto & Tsukasa Seya

  4. Mino Health Center, Mino, Japan

    Mariko Wada

  5. SNP Research Center, RIKEN Yokohama Institute, Yokohama, Japan

    Kumao Toyoshima

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  1. Ken Kodama
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  2. Masahiko Higashiyama
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  4. Kazuyuki Oda
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  6. Jun Maeda
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  7. Takashi Akazawa
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  8. Misako Matsumoto
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  9. Tsukasa Seya
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  11. Kumao Toyoshima
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Kodama, K., Higashiyama, M., Takami, K. et al. Innate immune therapy with a Bacillus Calmette-Guérin cell wall skeleton after radical surgery for non-small cell lung cancer: A case-control study. Surg Today 39, 194–200 (2009). https://doi.org/10.1007/s00595-008-3826-3

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  • DOI: https://doi.org/10.1007/s00595-008-3826-3

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