A lethally irradiated allogeneic granulocyte-macrophage colony stimulating factor-secreting tumor vaccine for pancreatic adenocarcinoma. A Phase II trial of safety, efficacy, and immune activation.

Abstract:

PURPOSE:Surgical resection provides the only possibility of cure for pancreas cancer. A standard adjuvant approach has not been established. We tested the safety and efficacy of a granulocyte-macrophage colony-stimulating factor (GM-CSF)-based immunotherapy administered in patients with resected pancreatic adenocarcinoma. PATIENTS AND METHODS:A single institution phase II study of 60 patients with resected pancreatic adenocarcinoma was performed. Each immunotherapy treatment consisted of a total of 5 × 108 GM-CSF-secreting cells distributed equally among 3 lymph node regions. The first immunotherapy treatment was administered 8 to 10 weeks after surgical resection. Subsequently, patients received 5-FU based chemoradiation. Patients who remained disease-free after completion of chemoradiotherapy received treatments 2 to 4, each 1 month apart. A fifth and final booster was administered 6 months after the fourth immunotherapy. The primary endpoint was disease free survival and secondary endpoints were overall survival and toxicity, and the induction of mesothelin specific T cell responses. RESULTS:The median disease-free survival is 17.3 months (95% CI, 14.6-22.8) with median survival of 24.8 months (95% CI, 21.2-31.6). The administration of immunotherapy was well tolerated. In addition, the post-immunotherapy induction of mesothelin-specific CD8+ T cells in HLA-A1+ and HLA-A2+patients correlates with disease-free survival. CONCLUSIONS:An immunotherapy approach integrated with chemoradiation is safe and demonstrates an overall survival that compares favorably with published data for resected pancreas cancer. These data suggest additional boost immunotherapies given at regular intervals beyond 1 year postsurgery should be tested in future studies, and provide the rationale for conducting a multicenter phase II study.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Lutz E,Yeo CJ,Lillemoe KD,Biedrzycki B,Kobrin B,Herman J,Sugar E,Piantadosi S,Cameron JL,Solt S,Onners B,Tartakovsky I,Choi M,Sharma R,Illei PB,Hruban RH,Abrams RA,Le D,Jaffee E,Laheru D

doi

10.1097/SLA.0b013e3181fd271c

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

328-35

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

253

pub_type

杂志文章
  • Microwave ablation for hepatic malignancies: a multiinstitutional analysis.

    abstract:OBJECTIVE:This study hypothesized that tumor size, number of tumors, surgical approach, and tumor histology significantly affected microwave ablation (MWA) success and recurrence-free survival. BACKGROUND:Although many hepatobiliary centers have adopted MWA, the factors that influence local control are not well descri...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000234

    authors: Groeschl RT,Pilgrim CH,Hanna EM,Simo KA,Swan RZ,Sindram D,Martinie JB,Iannitti DA,Bloomston M,Schmidt C,Khabiri H,Shirley LA,Martin RC,Tsai S,Turaga KK,Christians KK,Rilling WS,Gamblin TC

    更新日期:2014-06-01 00:00:00

  • Intrathymic injection of donor alloantigens induces donor-specific vascularized allograft tolerance without immunosuppression.

    abstract::The induction of donor-specific tolerance could prevent the side effects of immunosuppression while improving allograft survival. Male adult Buffalo (RT1b) rats underwent an intrathymic (IT), portal venous (PV), intrasplenic (IS), or subcutaneous (SQ) injection of 25 x 10(6) major histocompatibility complex (MHC) mism...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199210000-00003

    authors: Goss JA,Nakafusa Y,Flye MW

    更新日期:1992-10-01 00:00:00

  • Surgical management of abdominal aortic aneurysms: factors influencing mortality and morbidity--a 20-year experience.

    abstract::Abdominal aortic aneurysmectomy is being performed with progressively lower operative mortality and morbidity. Three hundred thirty seven patients have had elective aneurysm repair since 1954. Factors affecting mortality and morbidity in the last 108 cases are analyzed. Seventy-four per cent of patients had pre-existi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197505000-00020

    authors: Thompson JE,Hollier LH,Patman RD,Persson AV

    更新日期:1975-05-01 00:00:00

  • Peroral endoscopic drainage/debridement of walled-off pancreatic necrosis.

    abstract:BACKGROUND:Experience with minimal access, transoral/transmural endoscopic drainage/debridement of walled-off pancreatic necrosis (WOPN) after necrotizing pancreatitis is limited. We sought to determine outcome using this technique. METHODS:Retrospective analysis. RESULTS:From 1998 to 2006, 53 patients underwent tran...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000254366.19366.69

    authors: Papachristou GI,Takahashi N,Chahal P,Sarr MG,Baron TH

    更新日期:2007-06-01 00:00:00

  • Serum miR-200c is a novel prognostic and metastasis-predictive biomarker in patients with colorectal cancer.

    abstract:OBJECTIVE:To evaluate the ability of epithelial-to-mesenchymal transition-related microRNAs (miRNAs) as serum biomarkers for prognosis and prediction of metastasis in patients with colorectal cancer (CRC). BACKGROUND:Epithelial-to-mesenchymal transition-related miRNAs drive CRC progression and metastasis. However, the...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182a6909d

    authors: Toiyama Y,Hur K,Tanaka K,Inoue Y,Kusunoki M,Boland CR,Goel A

    更新日期:2014-04-01 00:00:00

  • Twenty-three-year follow-up of separated ischiopagus tetrapus conjoined twins.

    abstract::This paper presents a 23-year follow-up of the separation of ischiopagus tetrapus conjoined twins reported in Annals of Surgery in December 1966. One twin died of septicemia at age 2 years after bilateral pelvic osteotomies for the treatment of her marked pelvic diastasis. The surviving twin has done reasonably well, ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-198911000-00017

    authors: Hoyle RM,Thomas CG Jr

    更新日期:1989-11-01 00:00:00

  • Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative.

    abstract:OBJECTIVES:To develop a risk prediction model for serious complications after bariatric surgery. BACKGROUND:Despite evidence for improved safety with bariatric surgery, serious complications remain a concern for patients, providers and payers. There is little population-level data on which risk factors can be used to ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318230058c

    authors: Finks JF,Kole KL,Yenumula PR,English WJ,Krause KR,Carlin AM,Genaw JA,Banerjee M,Birkmeyer JD,Birkmeyer NJ,Michigan Bariatric Surgery Collaborative, from the Center for Healthcare Outcomes and Policy.

    更新日期:2011-10-01 00:00:00

  • Preoperative methylprednisolone enhances recovery after endovascular aortic repair: a randomized, double-blind, placebo-controlled clinical trial.

    abstract:OBJECTIVE:To evaluate effects of preoperative high-dose glucocorticoid on the inflammatory response and recovery after endovascular aortic aneurysm repair (EVAR). BACKGROUND:The postimplantation syndrome after EVAR may delay recovery due to the release of proinflammatory mediators. Glucocorticoids may reduce postopera...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000000895

    authors: de la Motte L,Kehlet H,Vogt K,Nielsen CH,Groenvall JB,Nielsen HB,Andersen A,Schroeder TV,Lönn L

    更新日期:2014-09-01 00:00:00

  • Bactericidal/permeability-increasing protein attenuates systemic inflammation and acute lung injury in porcine lower limb ischemia-reperfusion injury.

    abstract:OBJECTIVE:To investigate the role of recombinant bactericidal/permeability-increasing protein (rBPI21) in the attenuation of the sepsis syndrome and acute lung injury associated with lower limb ischemia-reperfusion (I/R) injury. SUMMARY BACKGROUND DATA:Gut-derived endotoxin has been implicated in the conversion of the...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200108000-00014

    authors: Harkin DW,Barros D'Sa AA,McCallion K,Hoper M,Halliday MI,Campbell FC

    更新日期:2001-08-01 00:00:00

  • Use of transcutaneous oxygen sensors to titrate PEEP.

    abstract::The relationship of transcutaneous oxygen tension (PtcO2) to arterial oxygen tension (PaO2), pulmonary shunt (Qsp/Qt), mixed venous oxygen tension (PVO2), and O2 delivery was determined in patients with respiratory failure in order to explore the possible usefulness of PtcO2 to titrate the level of positive end expira...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198102000-00014

    authors: Tremper KK,Waxman K,Shoemaker WC

    更新日期:1981-02-01 00:00:00

  • The Safer Delivery of Surgical Services Program (S3): Explaining Its Differential Effectiveness and Exploring Implications for Improving Quality in Complex Systems.

    abstract:OBJECTIVE:To analyze the challenges encountered during surgical quality improvement interventions, and explain the relative success of different intervention strategies. SUMMARY BACKGROUND DATA:Understanding why and how interventions work is vital for developing improvement science. The S3 Program of studies tested wh...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001583

    authors: Flynn LC,McCulloch PG,Morgan LJ,Robertson ER,New SJ,Stedman FE,Martin GP

    更新日期:2016-12-01 00:00:00

  • Somatostatin receptor gene therapy combined with targeted therapy with radiolabeled octreotide: a new treatment for liver metastases.

    abstract:OBJECTIVE:To evaluate the effect of peptide receptor radionuclide therapy (PRRT) on somatostatin receptor (SSR)-transfected colon carcinoma cells in a rat liver metastases model. SUMMARY BACKGROUND DATA:Previously the authors have shown highly effective therapy with PRRT of SSR-positive tumors. This treatment is SSR-m...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200212000-00004

    authors: Mearadji A,Breeman W,Hofland L,van Koetsveld P,Marquet R,Jeekel J,Krenning E,van Eijck C

    更新日期:2002-12-01 00:00:00

  • Lymph node ratio as a quality and prognostic indicator in stage III colon cancer.

    abstract:BACKGROUND:The presence and number of nodal metastasis significantly impact colon cancer prognosis. Similarly, the number of resected/evaluated nodes impacts staging accuracy. This ratio of metastatic to examined nodes or lymph node ratio (LNR) may have independent prognostic value in colon carcinoma. PURPOSE:: To eva...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181ffa780

    authors: Chen SL,Steele SR,Eberhardt J,Zhu K,Bilchik A,Stojadinovic A

    更新日期:2011-01-01 00:00:00

  • Recurrent carotid artery stenosis following endarterectomy.

    abstract::Spectral analysis was used to examine 257 carotid arteries in 227 patients who had undergone carotid endarterectomy at 1, 3, 6, and 12 months after surgery and annually thereafter. Routine intraoperative completion angiography ensured that the operations were technically satisfactory. Postoperative restenoses were ide...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198407000-00013

    authors: Thomas M,Otis SM,Rush M,Zyroff J,Dilley RB,Bernstein EF

    更新日期:1984-07-01 00:00:00

  • Pancreatic necrosis: results of necrosectomy, packing, and ultimate closure over drains.

    abstract:OBJECTIVE:The treatment of pancreatic necrosis at a tertiary referral center was reviewed to effect better patient outcome. SUMMARY BACKGROUND DATA:Pancreatic necrosis is a devastating disease that leads to death in 10% to 50% of cases. Infected necrosis is particularly deadly because 80% of deaths from necrosis are d...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199806000-00010

    authors: Branum G,Galloway J,Hirchowitz W,Fendley M,Hunter J

    更新日期:1998-06-01 00:00:00

  • Thrombotic thrombocytopenic purpura (TTP) and splenectomy: a current appraisal.

    abstract::Thrombotic thrombocytopenic purpura (TTP) is a disease process characterized by microangiopathic anemia, fever, neurologic manifestations, renal abnormalities, and thrombocytopenia. These clinical findings are caused by vascular occlusions of the microcirculation. At present the utilization of splenectomy, in the trea...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197811000-00021

    authors: Rutkow IM

    更新日期:1978-11-01 00:00:00

  • Gastric carcinoma following operation for peptic ulcer disease.

    abstract::Gastric carcinoma following operation for benign peptic ulcer disease has been considered rare but nine patients have been seen during the past five years. All were male patients, the average time interval from prior ulcer operation to development of cancer was 17 years, but was a short as ten years. The symptoms of c...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197803000-00007

    authors: Eberlein TJ,Lorenzo FV,Webster MW

    更新日期:1978-03-01 00:00:00

  • Laparoscopic versus open appendectomy: a prospective randomized double-blind study.

    abstract:SUMMARY BACKGROUND DATA:The value of laparoscopy in appendicitis is not established. Studies suffer from multiple limitations. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a prospective randomized double blind study. METHODS:Two hundred forty-seven patients were analyzed fo...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.sla.0000179648.75373.2f

    authors: Katkhouda N,Mason RJ,Towfigh S,Gevorgyan A,Essani R

    更新日期:2005-09-01 00:00:00

  • Treatment of intra-abdominal and abdominal wall desmoid tumors with drugs that affect the metabolism of cyclic 3',5'-adenosine monophosphate.

    abstract::A female patient with Gardner's syndrome was treated with delta1-testololactone (200 mg daily) because of growth of a large desmoid tumor in the pelvis and lower abdomen and a tumor in a scar from a previous laparotomy. There was also pain and swelling of the left leg. An immediate effect of the drug therapy was compl...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197503000-00009

    authors: Waddell WR

    更新日期:1975-03-01 00:00:00

  • Carotid Artery Reactivity Predicts Events in Peripheral Arterial Disease Patients.

    abstract:OBJECTIVE:Patients with peripheral arterial disease (PAD) have increased risk on future cerebro- and cardiovascular events. Our aim was to examine whether carotid artery reactivity (CAR; a novel, simple procedure to examine endothelial function) predicts cardiovascular events in PAD patients. BACKGROUND:Increased risk...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002558

    authors: van Mil ACCM,Pouwels S,Wilbrink J,Warlé MC,Thijssen DHJ

    更新日期:2019-04-01 00:00:00

  • Perineural invasion and lymph node involvement as indicators of surgical outcome and pattern of recurrence in the setting of preoperative gemcitabine-based chemoradiation therapy for resectable pancreatic cancer.

    abstract:OBJECTIVE:To analyze the histopathological indicators significantly associated with surgical outcome and the pattern of recurrence in the setting of preoperative gemcitabine-based chemoradiation therapy (CRT) and subsequent pancreatectomy. BACKGROUND:Clinicopathological assessment of the resected specimen is an indisp...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31823d813c

    authors: Takahashi H,Ohigashi H,Ishikawa O,Gotoh K,Yamada T,Nagata S,Tomita Y,Eguchi H,Doki Y,Yano M

    更新日期:2012-01-01 00:00:00

  • Reductive surgery plus percutaneous isolated hepatic perfusion for multiple advanced hepatocellular carcinoma.

    abstract:OBJECTIVE:To evaluate the efficacy of a novel 2-stage treatment with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP) for multiple hepatocellular carcinoma (HCC), which was previously unresectable. SUMMARY BACKGROUND DATA:Surgical resection is the treatment of choice for HCC, but the majority of p...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.sla.0000103133.03688.3d

    authors: Ku Y,Iwasaki T,Tominaga M,Fukumoto T,Takahashi T,Kido M,Ogata S,Takahashi M,Kuroda Y,Matsumoto S,Obara H

    更新日期:2004-01-01 00:00:00

  • Long-term results of brachial thrombectomy following cardiac catheterization.

    abstract::The late results of brachial thrombectomy following cardiac catheterization were evaluated in 20 patients. All patients had a radial pulse present and no symptoms or signs of ischemia of the hand at the time of discharge from the hospital. Late evaluation of these 20 patients revealed 8 in whom the long-term results w...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197604000-00019

    authors: Nicholas GG,DeMuth WE Jr

    更新日期:1976-04-01 00:00:00

  • Longitudinal pancreaticojejunostomy in chronic relapsing pancreatitis with onset in childhood.

    abstract::Despite the rarity of chronic relapsing pancreatitis in children, in the last 15 years at Vanderbilt University Medical Center and its Children's Hospital we have used longitudinal pancreaticojejunostomy in treatment of eight patients whose symptoms began in childhood. Duration of symptoms ranged from 2 to 36 years. S...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198405000-00017

    authors: Scott HW Jr,Neblett WW,O'Neill JA Jr,Sawyers JL,Avant GS,Starnes VA

    更新日期:1984-05-01 00:00:00

  • Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands.

    abstract:OBJECTIVE:To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA:Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-te...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199904000-00016

    authors: Sheridan RL,Baryza MJ,Pessina MA,O'Neill KM,Cipullo HM,Donelan MB,Ryan CM,Schulz JT,Schnitzer JJ,Tompkins RG

    更新日期:1999-04-01 00:00:00

  • Influence of total parenteral nutrition on tissue lipoprotein lipase activity during chronic and acute illness.

    abstract::This study examines the influence of total parenteral nutrition (TPN) compared with 5% dextrose (D5) infusion on skeletal muscle and adipose tissue lipoprotein lipase (LPL) activity in nutritionally depleted, injured and infected patients. The plasma concentrations of glucose, free fatty acid (FFA), triglyceride and i...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198112000-00003

    authors: Robin AP,Greenwood MR,Askanazi J,Elwyn DH,Kinney JM

    更新日期:1981-12-01 00:00:00

  • Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging.

    abstract::A method of clinical staging for infants with necrotizing enterocolitis (NEC) is proposed. On the basis of assigned stage at the time of diagnosis, 48 infants were treated with graded intervention. For Stage I infants, vigorous diagnostic and supportive measures are appropriate. Stage II infants are treated medically,...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197801000-00001

    authors: Bell MJ,Ternberg JL,Feigin RD,Keating JP,Marshall R,Barton L,Brotherton T

    更新日期:1978-01-01 00:00:00

  • Surgical adverse outcomes in patients with schizophrenia: a population-based study.

    abstract:OBJECTIVE:To validate the global features of postoperative adverse outcomes for surgical patients with schizophrenia. BACKGROUND:Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwar...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0b013e31827b9b25

    authors: Liao CC,Shen WW,Chang CC,Chang H,Chen TL

    更新日期:2013-03-01 00:00:00

  • "Keyhole" coronary artery bypass surgery.

    abstract:OBJECTIVE:The objective of this study was to identify the utility of "keyhole" thoracotomy approaches to single vessel coronary artery bypass surgery. SUMMARY BACKGROUND DATA:Although minimally invasive surgery is efficacious in a wide variety of surgical disciplines, it has been slow to emerge in cardiac surgery. Amo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199610000-00004

    authors: Landreneau RJ,Mack MJ,Magovern JA,Acuff TA,Benckart DH,Sakert TA,Fetterman LS,Griffith BP

    更新日期:1996-10-01 00:00:00

  • Total pancreatectomy with preservation of the duodenum and pylorus for chronic pancreatitis.

    abstract::In an effort to minimize the nutritional complications that follow resection of the pancreas for severe chronic pancreatitis, the authors have performed a duodenum-preserving total pancreatectomy in eight patients for severe unremitting pain requiring large doses of opiate analgesia. Good relief of pain was obtained i...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199111000-00007

    authors: Easter DW,Cuschieri A

    更新日期:1991-11-01 00:00:00