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Department of Medicine, Division of Medical Oncology, Thomas Jefferson University [D. B., H. C. M., M. J. M.], and the Department of Dermatology, Hahnemann Medical College [H. C. M.], Philadelphia, Pennsylvania 19107
There is considerable evidence in animal tumor systems that antitumor immunity is modulated by suppressor T-lymphocytes, and that the cytotoxic drug cyclophosphamide (CY) can abrogate that suppression. We measured the acquisition of delayed-type hypersensitivity (DTH) to autologous melanoma cells in 19 patients with metastatic malignant melanoma. The patients were treated with an autologous melanoma cell vaccine, either given alone, or given 3 days after the administration of CY, 300 mg/m2 i.v. The DTH responses of CY-pretreated patients were significantly greater than those of control (vaccine only) patients. Thus, after two vaccine treatments, the median DTH responses (mm induration) were as follows: controls, 4 mm; CY pretreated, 11 mm; P = 0.034, Mann-Whitney U test, 2-tailed. Whereas seven of eight CY-pretreated patients developed DTH to autologous melanoma cells of at least 5 mm, only two of seven controls did so (P = 0.034, Fisher's exact test). Two patients had significant antitumor responses to treatment with CY plus vaccine, consisting of complete disappearance of skin metastases and a pulmonary nodule in one, and regression of s.c. and liver metastases in the other. Both patients remain free of melanoma after 42 and 33 mo, respectively.
1 Recipient of a grant from the National Cancer Institute (CA39248). To whom requests for reprints should be addressed, at the Division of Medical Oncology, Thomas Jefferson University, 1005 Curtis, 1015 Walnut St., Philadelphia, PA 19107.
Received 10/25/85. Revised 1/ 2/86. Accepted 1/24/86.
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