Active specific immunotherapy for stage II and stage III human colon cancer: A randomised trial

Jan B. Vermorken; Anke M E Claessen; Harm Van Tinteren; Helen E. Gall; Renate Ezinga; Sybren Meijer; Rik J. Scheper; Chris J L M Meijer; Elizabeth Bloemena; Janet H. Ransom; Michael G. Hanna; Herbert M. Pinedo

doi:10.1016/S0140-6736(98)07186-4

Active specific immunotherapy for stage II and stage III human colon cancer: A randomised trial

Jan B. Vermorken, Anke M E Claessen, Harm Van Tinteren, Helen E. Gall, Renate Ezinga, Sybren Meijer, Rik J. Scheper, Chris J L M Meijer, Elizabeth Bloemena, Janet H. Ransom, Michael G. Hanna, Herbert M. Pinedo

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Abstract

Background. Colon cancer is curable by surgery, but cure rate depends on the extent of disease. We investigated whether adjuvant active specific immunotherapy (ASI) with an autologous tumour cell-BCG vaccine with surgical resection was more beneficial than resection alone in stage II and III colon cancer. Methods. In a prospective randomised trial, 254 patients with colon cancer were randomly assigned postoperative ASI or no adjuvant treatment. ASI was three weekly vaccinations starting 4 weeks after surgery, with a booster vaccination at 6 months with 10⁷ irradiated autologous tumour cells. The first vaccinations contained 10⁷ BCG organisms. We followed up patients for time to recurrence, and recurrence-free and overall survival. Analysis was by intention to treat. Findings. The 5.3 year median follow-up (range 8 months to 8 years 11 months) showed 44% (95% Cl 7-66) risk reduction for recurrence in the recurrence-free period in all patients receiving ASI (p = 0.023). Overall, there were 40 recurrences in the control group and 25 in the ASI group. Analysis by stage showed no significant benefit of ASI in stage III disease. The major impact of ASI was seen in patients with stage II disease, with a significantly longer recurrence-free period (p = 0.011) and 61% (18-81) risk reduction for recurrences. Recurrence-free survival was significantly longer with ASI (42% risk reduction for recurrence or death [0-68], p = 0.032) and there was a trend towards improved overall survival. Interpretation. ASI gave significant clinical benefit in surgically resected patients with stage II colon cancer. ASI has minimal adverse reactions and should be considered in the management of stage II colon cancer.

Original language	English (US)
Pages (from-to)	345-350
Number of pages	6
Journal	The Lancet
Volume	353
Issue number	9150
DOIs	https://doi.org/10.1016/S0140-6736(98)07186-4
State	Published - Jan 30 1999
Externally published	Yes

ASJC Scopus subject areas

General Medicine

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Vermorken, J. B., Claessen, A. M. E., Van Tinteren, H., Gall, H. E., Ezinga, R., Meijer, S., Scheper, R. J., Meijer, C. J. L. M., Bloemena, E., Ransom, J. H., Hanna, M. G., & Pinedo, H. M. (1999). Active specific immunotherapy for stage II and stage III human colon cancer: A randomised trial. The Lancet, 353(9150), 345-350. https://doi.org/10.1016/S0140-6736(98)07186-4

@article{431e0cc08f964a0d95514e0907bf2dbe,

title = "Active specific immunotherapy for stage II and stage III human colon cancer: A randomised trial",

abstract = "Background. Colon cancer is curable by surgery, but cure rate depends on the extent of disease. We investigated whether adjuvant active specific immunotherapy (ASI) with an autologous tumour cell-BCG vaccine with surgical resection was more beneficial than resection alone in stage II and III colon cancer. Methods. In a prospective randomised trial, 254 patients with colon cancer were randomly assigned postoperative ASI or no adjuvant treatment. ASI was three weekly vaccinations starting 4 weeks after surgery, with a booster vaccination at 6 months with 107 irradiated autologous tumour cells. The first vaccinations contained 107 BCG organisms. We followed up patients for time to recurrence, and recurrence-free and overall survival. Analysis was by intention to treat. Findings. The 5.3 year median follow-up (range 8 months to 8 years 11 months) showed 44% (95% Cl 7-66) risk reduction for recurrence in the recurrence-free period in all patients receiving ASI (p = 0.023). Overall, there were 40 recurrences in the control group and 25 in the ASI group. Analysis by stage showed no significant benefit of ASI in stage III disease. The major impact of ASI was seen in patients with stage II disease, with a significantly longer recurrence-free period (p = 0.011) and 61% (18-81) risk reduction for recurrences. Recurrence-free survival was significantly longer with ASI (42% risk reduction for recurrence or death [0-68], p = 0.032) and there was a trend towards improved overall survival. Interpretation. ASI gave significant clinical benefit in surgically resected patients with stage II colon cancer. ASI has minimal adverse reactions and should be considered in the management of stage II colon cancer.",

author = "Vermorken, {Jan B.} and Claessen, {Anke M E} and {Van Tinteren}, Harm and Gall, {Helen E.} and Renate Ezinga and Sybren Meijer and Scheper, {Rik J.} and Meijer, {Chris J L M} and Elizabeth Bloemena and Ransom, {Janet H.} and Hanna, {Michael G.} and Pinedo, {Herbert M.}",

year = "1999",

month = jan,

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doi = "10.1016/S0140-6736(98)07186-4",

language = "English (US)",

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pages = "345--350",

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TY - JOUR

T1 - Active specific immunotherapy for stage II and stage III human colon cancer

T2 - A randomised trial

AU - Vermorken, Jan B.

AU - Claessen, Anke M E

AU - Van Tinteren, Harm

AU - Gall, Helen E.

AU - Ezinga, Renate

AU - Meijer, Sybren

AU - Scheper, Rik J.

AU - Meijer, Chris J L M

AU - Bloemena, Elizabeth

AU - Ransom, Janet H.

AU - Hanna, Michael G.

AU - Pinedo, Herbert M.

PY - 1999/1/30

Y1 - 1999/1/30

N2 - Background. Colon cancer is curable by surgery, but cure rate depends on the extent of disease. We investigated whether adjuvant active specific immunotherapy (ASI) with an autologous tumour cell-BCG vaccine with surgical resection was more beneficial than resection alone in stage II and III colon cancer. Methods. In a prospective randomised trial, 254 patients with colon cancer were randomly assigned postoperative ASI or no adjuvant treatment. ASI was three weekly vaccinations starting 4 weeks after surgery, with a booster vaccination at 6 months with 107 irradiated autologous tumour cells. The first vaccinations contained 107 BCG organisms. We followed up patients for time to recurrence, and recurrence-free and overall survival. Analysis was by intention to treat. Findings. The 5.3 year median follow-up (range 8 months to 8 years 11 months) showed 44% (95% Cl 7-66) risk reduction for recurrence in the recurrence-free period in all patients receiving ASI (p = 0.023). Overall, there were 40 recurrences in the control group and 25 in the ASI group. Analysis by stage showed no significant benefit of ASI in stage III disease. The major impact of ASI was seen in patients with stage II disease, with a significantly longer recurrence-free period (p = 0.011) and 61% (18-81) risk reduction for recurrences. Recurrence-free survival was significantly longer with ASI (42% risk reduction for recurrence or death [0-68], p = 0.032) and there was a trend towards improved overall survival. Interpretation. ASI gave significant clinical benefit in surgically resected patients with stage II colon cancer. ASI has minimal adverse reactions and should be considered in the management of stage II colon cancer.

AB - Background. Colon cancer is curable by surgery, but cure rate depends on the extent of disease. We investigated whether adjuvant active specific immunotherapy (ASI) with an autologous tumour cell-BCG vaccine with surgical resection was more beneficial than resection alone in stage II and III colon cancer. Methods. In a prospective randomised trial, 254 patients with colon cancer were randomly assigned postoperative ASI or no adjuvant treatment. ASI was three weekly vaccinations starting 4 weeks after surgery, with a booster vaccination at 6 months with 107 irradiated autologous tumour cells. The first vaccinations contained 107 BCG organisms. We followed up patients for time to recurrence, and recurrence-free and overall survival. Analysis was by intention to treat. Findings. The 5.3 year median follow-up (range 8 months to 8 years 11 months) showed 44% (95% Cl 7-66) risk reduction for recurrence in the recurrence-free period in all patients receiving ASI (p = 0.023). Overall, there were 40 recurrences in the control group and 25 in the ASI group. Analysis by stage showed no significant benefit of ASI in stage III disease. The major impact of ASI was seen in patients with stage II disease, with a significantly longer recurrence-free period (p = 0.011) and 61% (18-81) risk reduction for recurrences. Recurrence-free survival was significantly longer with ASI (42% risk reduction for recurrence or death [0-68], p = 0.032) and there was a trend towards improved overall survival. Interpretation. ASI gave significant clinical benefit in surgically resected patients with stage II colon cancer. ASI has minimal adverse reactions and should be considered in the management of stage II colon cancer.

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DO - 10.1016/S0140-6736(98)07186-4

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AN - SCOPUS:0033616482

SN - 0140-6736

VL - 353

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EP - 350

JO - The Lancet

JF - The Lancet

IS - 9150

ER -

Active specific immunotherapy for stage II and stage III human colon cancer: A randomised trial

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