A randomized phase II study of SRL172 (Mycobacterium vaccae) combined with chemotherapy in patients with advanced inoperable non-small-cell lung cancer and mesothelioma

M. E R O'Brien, A. Saini, I. E. Smith, A. Webb, K. Gregory, R. Mendes, Christopher Ryan, K. Priest, K. V. Bromelow, R. D. Palmer, N. Tuckwell, D. A. Kennard, B. E. Souberbielle

Research output: Contribution to journalArticle

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Abstract

Mycobacterial preparations have been used with limited success against cancer apart from superficial bladder cancer. Recently, a therapeutic vaccine derived from Mycobacterium vaccae has been given to patients with prostate cancer and melanoma indicating a possible beneficial effect on disease activity in such patients. We have recently initiated a series of randomized studies to test the feasibility and toxicity of combining a preparation of heat-killed Mycobacterium vaccae (designated SRL172) with a multidrug chemotherapy regimen to treat patients with inoperable non-small cell lung cancer (NSCLC) and mesothelioma. 28 evaluable patients with previously untreated symptomatic NSCLC and mesothelioma were randomized to receive either 3 weekly intravenous combination chemotherapy alone, or chemotherapy given with monthly intra-dermal injections of SRL172. Safety and tolerability were scored by common toxicity criteria and efficacy was evaluated by survival of patients and by tumour response assessed by CT scanning. The toxicity of chemotherapy was similar in the two groups. SRL172 caused mild inflammation at the injection site. In the group of patients randomized to receive chemotherapy combined with SRL172, there was a trend towards improved response rate (54% vs. 33%) with more patients in the combined arm receiving radical surgery and radiotherapy, improved median survival (9.7 months vs. 7.5 months) and improved 1 year survival (42% vs. 18%). SRL172 appeared to improve sleep (P = 0.08) and improved appetite (P = 0.01). There was no detectable change n serum cytokine levels for gamma-interferon and TNF-α before and after treatment. In patients with NSCLC and mesothelioma, there may be a beneficial interaction when chemotherapy is administered in combination with SRL172. Confirmation of this effect and further investigation is underway in a randomized phase ill trial and in laboratory models. (C) 2000 Cancer Research Campaign.

Original languageEnglish (US)
Pages (from-to)853-857
Number of pages5
JournalBritish Journal of Cancer
Volume83
Issue number7
StatePublished - 2000
Externally publishedYes

Fingerprint

Mesothelioma
Mycobacterium
Non-Small Cell Lung Carcinoma
Drug Therapy
Survival
Toxicity Tests
Injections
SRL172
Appetite
Combination Drug Therapy
Urinary Bladder Neoplasms
Interferon-gamma
Melanoma
Neoplasms
Prostatic Neoplasms
Sleep
Radiotherapy
Vaccines
Hot Temperature
Cytokines

Keywords

  • Chemotherapy
  • Lung cancer
  • Mesothelioma
  • Mycobacterium vaccae
  • SRL172

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

O'Brien, M. E. R., Saini, A., Smith, I. E., Webb, A., Gregory, K., Mendes, R., ... Souberbielle, B. E. (2000). A randomized phase II study of SRL172 (Mycobacterium vaccae) combined with chemotherapy in patients with advanced inoperable non-small-cell lung cancer and mesothelioma. British Journal of Cancer, 83(7), 853-857.

A randomized phase II study of SRL172 (Mycobacterium vaccae) combined with chemotherapy in patients with advanced inoperable non-small-cell lung cancer and mesothelioma. / O'Brien, M. E R; Saini, A.; Smith, I. E.; Webb, A.; Gregory, K.; Mendes, R.; Ryan, Christopher; Priest, K.; Bromelow, K. V.; Palmer, R. D.; Tuckwell, N.; Kennard, D. A.; Souberbielle, B. E.

In: British Journal of Cancer, Vol. 83, No. 7, 2000, p. 853-857.

Research output: Contribution to journalArticle

O'Brien, MER, Saini, A, Smith, IE, Webb, A, Gregory, K, Mendes, R, Ryan, C, Priest, K, Bromelow, KV, Palmer, RD, Tuckwell, N, Kennard, DA & Souberbielle, BE 2000, 'A randomized phase II study of SRL172 (Mycobacterium vaccae) combined with chemotherapy in patients with advanced inoperable non-small-cell lung cancer and mesothelioma', British Journal of Cancer, vol. 83, no. 7, pp. 853-857.
O'Brien, M. E R ; Saini, A. ; Smith, I. E. ; Webb, A. ; Gregory, K. ; Mendes, R. ; Ryan, Christopher ; Priest, K. ; Bromelow, K. V. ; Palmer, R. D. ; Tuckwell, N. ; Kennard, D. A. ; Souberbielle, B. E. / A randomized phase II study of SRL172 (Mycobacterium vaccae) combined with chemotherapy in patients with advanced inoperable non-small-cell lung cancer and mesothelioma. In: British Journal of Cancer. 2000 ; Vol. 83, No. 7. pp. 853-857.
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abstract = "Mycobacterial preparations have been used with limited success against cancer apart from superficial bladder cancer. Recently, a therapeutic vaccine derived from Mycobacterium vaccae has been given to patients with prostate cancer and melanoma indicating a possible beneficial effect on disease activity in such patients. We have recently initiated a series of randomized studies to test the feasibility and toxicity of combining a preparation of heat-killed Mycobacterium vaccae (designated SRL172) with a multidrug chemotherapy regimen to treat patients with inoperable non-small cell lung cancer (NSCLC) and mesothelioma. 28 evaluable patients with previously untreated symptomatic NSCLC and mesothelioma were randomized to receive either 3 weekly intravenous combination chemotherapy alone, or chemotherapy given with monthly intra-dermal injections of SRL172. Safety and tolerability were scored by common toxicity criteria and efficacy was evaluated by survival of patients and by tumour response assessed by CT scanning. The toxicity of chemotherapy was similar in the two groups. SRL172 caused mild inflammation at the injection site. In the group of patients randomized to receive chemotherapy combined with SRL172, there was a trend towards improved response rate (54{\%} vs. 33{\%}) with more patients in the combined arm receiving radical surgery and radiotherapy, improved median survival (9.7 months vs. 7.5 months) and improved 1 year survival (42{\%} vs. 18{\%}). SRL172 appeared to improve sleep (P = 0.08) and improved appetite (P = 0.01). There was no detectable change n serum cytokine levels for gamma-interferon and TNF-α before and after treatment. In patients with NSCLC and mesothelioma, there may be a beneficial interaction when chemotherapy is administered in combination with SRL172. Confirmation of this effect and further investigation is underway in a randomized phase ill trial and in laboratory models. (C) 2000 Cancer Research Campaign.",
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