We demonstrated that the prognosis of breast cancer patients who received adjuvant immunochemotherapy with Krestin (PSK) showed a tendency to be better than that of breast cancer patients receiving chemotherapy only. We retrospectively investigated the usefulness of HLA typing for selecting patients to receive adjuvant immuno-chemotherapy with PSK. One hundred and thirty-four patients with operable breast cancer were typed as HLA-A, -B, -C by a lymphocytotoxicity test. Patients without vascular invasion had no adjuvant therapy (NA group). Patients with vascular invasion in the tumor and/or in the metastatic lymph node were randomized into two groups. In group 1 (FEMP only), a combination chemotherapy of 100 mg of 5-fluorouracil (F), 50 mg of cyclophosphamide (E), 2 mg of mitomycin C (M), and 5 mg of predonisolone (P) was orally administered daily for 28 days (one course). In group 2 (FEMP+PSK), FEMP and 3.0 g of PSK were orally administered for 28 days (one course). Two courses a year of these agents were given for five years in both groups. Each group (NA, FEMP, FEMP+PSK) was stratified by the presence of HLA B40 type (B40(+)) or not (B40(-)). Five- and 10-year disease-free survival (DFS) rates (93%, 80%, respectively) of patients with B40(+) seemed to be better than those (83% and 51%) of patients with B40(-). In the NA group, 5- and 10-year DFS were 100% and 71% in patients with B40(+), 92% and 76% in those with B40(-), respectively. In the FEMP group (chemotherapy only), 5- and 10-year DFS of patients with B40(+) were both 84%. These were not statistically significant compared with those (82% and 33%) of patients with B40(-). On the other hand, in the FEMP+PSK group, 5- and 10-year DFS of patients with B40(+) were both 100%, and those of patients with B40(-) were 76% and 55%, respectively. DFS of patients with B40(+) was significantly better than that of patients with B40(-). It is concluded that HLA typing may be a predictive index in determining the use of immunochemotherapy combined with PSK for patients with operable breast cancer.
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【HLA antigen as predictive index for the outcome of breast cancer patients with adjuvant immunochemotherapy with PSK.].
【HLA抗原作为PSK辅助免疫化疗乳腺癌患者预后的预测指标。】
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我们证明，接受Krestin (PSK) 辅助免疫化疗的乳腺癌患者的预后显示出比仅接受化疗的乳腺癌患者更好的趋势。我们回顾性研究了HLA分型对选择接受PSK辅助免疫化疗的患者的有用性。通过淋巴细胞毒性试验将134例可手术的乳腺癌患者分为hla-a，-B，-C。无血管侵犯的患者没有辅助治疗 (NA组)。肿瘤和/或转移淋巴结中血管浸润的患者被随机分为两组。在第1组 (仅FEMP) 中，每天口服给药100 mg 5-氟尿嘧啶 (F)，50 mg环磷酰胺 (E)，2 mg丝裂霉素c (M) 和5 mg泼尼松龙 (P) 的联合化疗，持续28天 (一个疗程)。在第2组 (FEMP + PSK) 中，FEMP和3.0g PSK口服给药28天 (一个疗程)。在两组中，这些代理商每年接受两次课程，为期五年。每组 (NA，FEMP，FEMP PSK) 均通过存在HLA B40型 (B40 ()) 或不存在 (B40(-)) 进行分层。B40(+) 患者的5年和10年无病生存率 (DFS) (分别为93% 、80%) 似乎优于B40(-) 患者的 (83% 和51%)。在NA组中，B40(-) 患者的5年和10年DFS分别100% 和71%，B40(-) 患者的92% 和76%。在FEMP组 (仅化疗) 中，B40(+) 患者的5年和10年DFS均为84%。与B40(-) 患者的 (82% 和33%) 相比，这些没有统计学意义。另一方面，在FEMP PSK组中，B40 () 患者的5年和10年DFS均为100%，B40(-) 患者的5年和10年DFS分别为76% 和55%。B40(+) 患者的DFS显著优于B40(-) 患者。结论HLA分型可能是确定免疫化疗联合PSK用于可手术乳腺癌患者的预测指标。
