Long Survival of Patients with Small Cell Lung Cancer after Adjuvant Treatment with the Anti-Idiotypic Antibody BEC2 Plus Bacillus Calmette-Guérin

• Published in: Clinical cancer research 1999-06, Vol.5 (6), p.1319-1323
• Main Authors: GRANT, S. C, KRIS, M. G, HOUGHTON, A. N, CHAPMAN, P. B
• Format: Article
• Language: English
• Subjects: Adjuvants, Immunologic - adverse effects; Adjuvants, Immunologic - therapeutic use; Adult; Aged; Antibodies, Anti-Idiotypic - adverse effects; Antibodies, Anti-Idiotypic - therapeutic use; Antineoplastic agents; BCG Vaccine - therapeutic use; Biological and medical sciences; Carcinoma, Small Cell - immunology; Carcinoma, Small Cell - mortality; Carcinoma, Small Cell - therapy; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Disease-Free Survival; Female; Gangliosides - immunology; Humans; Immunoglobulin G - blood; Immunoglobulin M - blood; Immunotherapy, Active; Lung Neoplasms - immunology; Lung Neoplasms - mortality; Lung Neoplasms - therapy; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Survival Rate
• ISSN: 1078-0432; 1557-3265

Despite active therapies for small cell lung cancer (SCLC), most patients relapse and die of the disease. The present study evaluates immunization using the anti-idiotypic antibody BEC2, which mimics the ganglioside GD3 expressed on the surface of most SCLC tumors, combined with Bacillus Calmette - Guérin (BCG) as an immune adjuvant. We hypothesized that active immunization could alter the natural history of the disease. Fifteen patients who had completed standard therapy for SCLC received a series of five intradermal immunizations consisting of 2.5 mg of BEC2 plus BCG over a 10-week period. Blood was collected for serological analysis, and outcome was monitored. All patients developed anti-BEC2 antibodies, despite having received chemotherapy with or without thoracic radiation. We detected anti-GD3 antibodies in five patients, including those with the longest relapse-free survival. The median relapse-free survival for patients with extensive stage disease is 11 months and has not been reached for patients with limited stage disease (>47 months), with only one of seven patients having relapsed after a median follow-up of 47 months. Immunization of patients with SCLC after standard therapy using BEC2 plus BCG can induce anti-GD3 antibodies and is safe. The survival and relapse-free survival in this group of patients are substantially better than those observed in a prior group of similar patients. A Phase III trial is being conducted to evaluate BEC2 plus BCG as adjuvant therapy after chemotherapy and irradiation.