Abstract • Antibody against a breast carcinoma antigen was present in patients with breast carcinoma and other cancer more often (P <.05) than in normal women. The incidence of antibody in women with breast carcinoma correlated with the presence or absence of gross tumor, and the titer of antibody paralleled the clinical course. These results suggest the importance of a host-immune response to breast carcinoma. Fifty-seven patients with stage II carcinoma of the breast were entered into a prospective randomized adjuvant chemoimmunotherapy program of cyclophosphamide, methotrexate, and fluorouracil, and BCG vaccine ± an irradiated allogeneic tumor cell vaccine. After 24 months of study, metastases occurred in two patients (3.5%) and a new primary carcinoma developed in the contralateral breast in two others, for an overall treatment failure rate of 7%. Adjuvant chemoimmunotherapy can delay early recurrence. Long-term follow-up is needed to assess the significance of these results. (Arch Surg 111:1057-1062, 1976) References 1. Beatson GT: On the treatment of inoperable cases of carcinoma of the mamma: Suggestions for a new method of treatment, with illustrative cases . Lancet 2:104-107, 1896.Crossref 2. Fisher B, Carbone P, Economou SG, et al: L-phenylalanine mustard (L-PAM) in the management of primary breast cancer: A report of early findings . N Engl J Med 292:117-122, 1975.Crossref 3. Bonadonna G, Brusamolina E, Valagussa P, et al: Combination chemotherapy as an adjuvant treatment in operable breast cancer . N Engl J Med 294:405-410, 1976.Crossref 4. Alford TC: Chemotherapy of disseminated breast cancer . Surg Gynecol Obstet 117:634-635, 1963. 5. Berg JW: Morphological evidence for immune responses to breast cancer . Cancer 28:1453-1456, 1971.Crossref 6. Black MM, Speer FD: Sinus histiocytosis of lymph nodes in cancer . Surg Gynecol Obstet 106:163-175, 1958. 7. Humphrey LJ, Estes NC, Morse PA, et al: Serum antibody in patients with breast disease: Correlation with histopathology . Ann Surg 180:124-129, 1974.Crossref 8. Priori ES, Seman G, Dmochowski L, et al: Immunofluorescence studies on sera of patients with breast carcinoma . Cancer 28:1462-1471, 1971.Crossref 9. Hellström I, Hellström KE, Pierce GE, et al: Cellular and humoral immunity to different types of human neoplasms . Nature 220:1352-1354, 1968.Crossref 10. Gupta RK, Morton DL: Suggested evidence for in vivo binding of specific antitumor antibodies of human melanomas . Cancer Res 35:58-62, 1975. 11. Oren ME, Herberman RB: Delayed cutaneous hypersensitivity reactions to membrane extracts of human tumour cells . Clin Exp Immunol 9:45-56, 1971. 12. Sparks FC, Silverstein MJ, Hunt JS, et al: Complications of BCG immunotherapy in patients with cancer . N Engl J Med 289:827-830, 1973.Crossref 13. Cailleau R, Young R, Olivé M, et al: Breast tumor cell lines from pleural effusions . J Natl Cancer Inst 53:661-666, 1974. 14. Klein G: The Epstein-Barr virus and neoplasia . N Engl J Med 293:1353-1357, 1975.Crossref 15. Canellos GP, Pocock SJ, Taylor SG III, et al: Combination chemotherapy for metastatic breast carcinoma: Prospective comparison of multiple drug therapy with l-phenylalanine mustard. Cancer, to be published. 16. Haskell CM, Sparks FC, Graze PR, et al: Systemic therapy for metastatic breast cancer. Ann Intern Med, to be published. 17. Hersh EM, Oppenheim JJ: Inhibition of in vitro lymphocyte transformation during chemotherapy in man . Cancer Res 27:98-105, 1967. 18. Humphrey GB, Nesbit ME Jr, Chary KKN, et al: Impaired lymphocyte transformation in leukemic patients after intensive therapy . Cancer 29:402-406, 1972.Crossref 19. Mitchell MS, Deconti RC: Immunosuppression by 5-fluorouracil . Cancer 26:884-889, 1970.Crossref 20. Gutterman JU, Mavligit G, Hersh EM, et al: Immunotherapy of cancer, malignant melanoma, and acute leukemia with BCG: Prolongation of disease-free interval and survival . Cancer Immunol Immunother 1:99-107, 1976.
Archives of Surgery – American Medical Association
Published: Oct 1, 1976