According to a recent, early online publication in the Journal of Clinical Oncology, immune cells from donors appear to have anti-cancer activity in patients with metastatic breast cancer who have stopped responding to standard therapies.

Breast cancer claims the lives of nearly 40,000 women each year in the United States. Most of these deaths are caused by cancer that has spread from its site of origin to distant sites in the body, referred to as metastatic breast cancer. Metastatic breast cancer often invades vital organs such as the liver, brain or bones. Metastatic breast cancer is largely considered an incurable disease with the present standard therapeutic approaches, and long-term survival remains dismal, particularly in patients who progress following prior therapy. Researchers are evaluating novel strategies for treatment of metastatic breast cancer to improve survival in this group of patients.

Donor lymphocyte infusion (DLI) is a treatment approach that has demonstrated anti-cancer activity and improved survival in some types of cancer, mainly cancers that affect the blood or immune system. This type of treatment includes the use of a donor’s lymphocytes, or type of immune cell, that are infused into the patient. The theory behind DLI is that the donor’s immune cells recognize the patient’s cancer cells as “foreign” and mount an attack against them, referred to as a “graft-versus-tumor” (GVT) effect.

Researchers from the National Cancer Institute (NCI) recently conducted a clinical trial to evaluate DLI in patients with metastatic breast cancer. This trial included 16 patients who had progressive cancer following treatment with several chemotherapy agents as well as biologic therapies. In this trial, patients underwent chemotherapy with cyclophosphamide and fludarabine, and then received stem cells (with lymphocytes removed) from a donor. They then received 3 separate DLIs. Approximately 27% (6 out of 16) patients experienced a regression in their cancer following DLIs. Two of these patients were experiencing cancer progression following treatment until DLI was delivered.

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The researchers concluded that DLI appears to produce a graft-versus-tumor effect in patients with metastatic breast cancer, achieving anti-cancer responses in a substantial portion of these patients. The researchers stated that further evaluation of DLI in breast cancer may represent a novel type of therapeutic approach, particularly for patients who have progressed following previous therapies. Patients with metastatic breast cancer or cancer that has progressed following several series of treatment regimens may wish to speak with their physician about the risks and benefits of participation in a clinical trial further evaluating DLI or other novel therapeutic approaches.

Reference: Bishop M, Fowler D, Marchigiani D, et al. Allogeneic lymphocytes induce tumor regression in advanced metastatic breast cancer. Journal of Clinical Oncology. 2004. Early on-line publication available at: http://www.jco.org/cgi/content/abstract/JCO.2004.01.127v1. Accessed September 2004.

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