Combined immunopharmaceutical therapy of patients with unresectable pancreatic carcinoma

Abstract

Background/aims: This paper presents the results of a prospective randomized study of targeting locoregional chemotherapy and targeting locoregional immunostimulation therapy implemented in 36, out of 66, patients with a histological diagnosis of pancreatic duct carcinoma seen by our group from 1991 to Sept. 1994.

Method and materials: Sixty-six patients with unresectable pancreatic duct carcinoma were separated into two groups. The first group received laparotomy (n = 30), with palliative gastric bypass (n = 8) or with palliative biliary bypass (n = 18). The second group received laparotomy (n = 36), with palliative gastric bypass (n = 9) or with palliative biliary bypass (n = 20), supplemented with locoregional immunostimulation and locoregional chemotherapy. This therapy consisted of ten days of infusion with Proleukin (IL2) and Imukin (gamma-IFN), emulsified in Lipidiol-Urographin. This infusion was performed five days trans-splenically and five days trans-tumorally. Fifteen days later, targeting locoregional chemotherapy was administered, again emulsified in Lipidiol-Urographin.

Results: All the patients in the first group are dead, with a mean survival of 4.5 months, as of November 1995. Presently, 47% (n = 17) of the second group have achieved a positive objective response, with a mean survival of 14.1 months. During re-exploration, eight patients became tumor free after pancreatic resection, which became feasible after our therapy and six are alive and have remained tumor free to date.

Conclusion: Targeting locoregional immunotherapy, combined with locoregional chemotherapy appears to be a promising therapy, meriting further consideration for clinical application in patients with unresectable pancreatic ductal carcinoma.