nach oben

Erschienen in:

01.04.2006 | Original Article

Efficacy of adjuvant Immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials

verfasst von: Junichi Sakamoto, Satoshi Morita, Koji Oba, Takanori Matsui, Michiya Kobayashi, Hiroaki Nakazato, Yasuo Ohashi, Meta-Analysis Group of the Japanese Society for Cancer of the Colon Rectum

Erschienen in: Cancer Immunology, Immunotherapy | Ausgabe 4/2006

Einloggen, um Zugang zu erhalten

Abstract

The benefits of immunochemotherapy employing the biological response modifier polysaccharide K (PSK) for patients with curatively resected colorectal cancer was reassessed by means of a meta-analysis of data with center randomization from 1,094 patients enrolled in three clinical trials. In all three trials, patients were followed up for at least 5 years after surgery and enrollment of the last patient and outcomes for standard chemotherapy were compared with those for chemotherapy plus PSK. The endpoints were overall survival and disease-free survival; and intent-to-treat analysis was performed without patient exclusion. Data were analyzed using the weighted average of the individual log hazard ratios. The overall survival risk ratio for all eligible patients was 0.71 (95% confidence interval (CI) : 0.55–0.90; P=0.006), and the disease-free survival risk ratio was 0.72 (95% CI: 0.58–0.90; P=0.003). The results of this meta-analysis suggest that adjuvant immunochemotherapy with PSK can improve both survival and disease-free survival of patients with curatively resected colorectal cancer.

Parkin DM, Bray FI, Devesa SS (2001) Cancer burden in the year 2000. The global picture. Eur J Cancer 37 Suppl 8:S4–S66CrossRefPubMed

Andre T, Boni C, Mounedji-Boudiaf L et al (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351CrossRefPubMed

Sakamoto J, Hamada C, Kodaira S et al (1999) Adjuvant therapy with oral fluoropyrimidines as main chemotherapeutic agents after curative resection for colorectal cancer: individual patient data meta-analysis of randomized trials. Jpn J Clin Oncol 29:78–86PubMedCrossRef

Meta-Analysis Group of the Japanese Society for Cancer of the Colon and Rectum and the Meta-Analysis Group in Cancer (2004) Efficacy of oral adjuvant therapy after resection of colorectal cancer: 5-year results from three randomized trials. J Clin Oncol 22:484–492

Moertel CG, Fleming TR, Macdonald JS et al (1990) Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 322:352–358PubMedCrossRef

Kobayashi H, Matsunaga K, Oguchi Y (1995) Antimetastatic effects of PSK (Krestin), a protein-bound polysaccharide obtained from basidiomycetes: an overview. Cancer Epidemiol Biomarkers Prev 4:275–281PubMed

Ikuzawa M, Matsunaga K, Nishiyama S et al (1988) Fate and distribution of an antitumor protein-bound polysaccharide PSK (Krestin). Int J Immunopharmacol 10:415–423CrossRefPubMed

Torisu M, Hayashi Y, Ishimitsu T et al (1990) Significant prolongation of disease-free period gained by oral polysaccharide K (PSK) administration after curative surgical operation of colorectal cancer. Cancer Immunol Immunother 31:261–268CrossRefPubMed

Mitomi T, Tsuchiya S, Iijima N et al (1992) Randomized, controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum (Kanagawa). Dis Colon Rectum 35:123–130CrossRefPubMed

10.

Nakazato H, Koike A, Saji S et al (1994) Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Lancet 343:1122–1126CrossRefPubMed

11.

Parmar MK, Torri V, Stewart L (1998) Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med 17:2815–2834PubMedCrossRef

12.

Ebina T, Murata K (1992) Antitumor effect of PSK at a distant site: tumor-specific immunity and combination with other chemotherapeutic agents. Jpn J Cancer Res 83:775–782PubMed

13.

Harada M, Matsunaga K, Oguchi Y et al (1997) Oral administration of PSK can improve the impaired anti-tumor CD4+T-cell response in gut-associated lymphoid tissue (GALT) of specific-pathogen-free mice. Int J Cancer 70:362–372CrossRefPubMed

14.

Matsunaga K, Morita I, Oguchi Y et al (1986) Restoration of immunologic responsiveness by PSK in tumor-bearing animals [in Japanese]. Gan To Kagaku Ryoho 13:3468–3475PubMed

15.

Kanoh T, Saito K, Matsunaga K et al (1994) Enhancement of the antitumor effect by the concurrent use of a monoclonal antibody and the protein-bound polysaccharide PSK in mice bearing a human cancer cell line. In Vivo 8:241–245PubMed

16.

Suo J, Tanaka N, Hizuta A et al (1994) Suppression of hepatic natural killer activity by liver metastasis of cancer and restoration of killer activity by oral administration of a Basidomycetes-derived polysaccharide, PSK. Acta Med Okayama 48:237–242PubMed

17.

Noguchi K, Tanimura H, Yamaue H et al (1995) Polysaccharide preparation PSK augments the proliferation and cytotoxicity of tumor-infiltrating lymphocytes in vitro. Anticancer Res 15:255–258PubMed

18.

Ebina T, Murata K (1995) Antitumor effect of intratumoral administration of BRM: inhibition of tumor cell invasion in vitro [in Japanese]. Gan To Kagaku Ryoho 22:1626–1628PubMed

19.

Sugiyama Y, Saji S, Miya K et al (1996) Locoregional therapy for liver metastases of colorectal cancer [in Japanese]. Gan To Kagaku Ryoho 23:1433–1436PubMed

20.

Kamei H, Hashimoto Y, Koide T et al (1997) Direct tumor growth suppressive effect of melanoidin extracted from immunomodulator-PSK. Cancer Biother Radiopharm 12:341–344PubMedCrossRef

21.

Ogihara H, Takenoshita S, Yajima Y et al (1998) The efficacy of immunochemotherapy with strontium (Sr) in the 1,2-dimethylhydrazine (DMH) induced rat carcinogenetic model: ultrastructural characteristics of the mitochondria in the liver. Anticancer Res 18:159–164PubMed

22.

Matsunaga K, Hosokawa A, Oohara M et al (1998). Direct action of a protein-bound polysaccharide, PSK, on transforming growth factor-beta. Immunopharmacology 40:219–230CrossRefPubMed

23.

Matsunaga K, Iijima H, Kobayashi H (2000) Neonatal inoculation with the protein-bound polysaccharide PSK increases resistance of adult animals to challenge with syngeneic tumor cells and reduces azoxymethane-induced precancerous lesions in the colon. Cancer Epidemiol Biomarkers Prev 9:1313–1322PubMed

24.

Okuzawa M, Shinohara H, Kobayashi T et al (2002) PSK, a protein-bound polysaccharide, overcomes defective maturation of dendritic cells exposed to tumor-derived factors in vitro. Int J Oncol 20:1189–1195PubMed

25.

Wada T, Iijima H, Sekine F et al (2003) Effect of PSK on Th1/Th2 balance in tumor-bearing mice [in Japanese]. Gan To Kagaku Ryoho 30: 1798–1801PubMed

26.

Yoshikawa R, Yanagi H, Hashimoto-Tamaoki T et al (2004) Gene expression in response to anti-tumor intervention by polysaccharide-K (PSK) in colorectal carcinoma cells. Oncol Rep 12:1287–1293PubMed

27.

Yasutomi M (1986) Surgery and adjuvant therapy of cancer of the large intestine [in Japanese]. Gan To Kagaku Ryoho 13:2307–2317PubMed

28.

Sakamoto J, Kato J, Yasue M (1998) Surgery and multidisciplinary treatment for colorectal cancer [in Japanese]. Gan To Kagaku Ryoho 25: 208–215PubMed

29.

Kidd PM (2000) The use of mushroom glucans and proteoglycans in cancer treatment. Altern Med Rev 5:4–27PubMed

30.

Fisher M, Yang LX (2002) Anticancer effects and mechanisms of polysaccharide-K (PSK): implications of cancer immunotherapy. Anticancer Res 22:1737–1754PubMed

31.

Kimura K, Tuchiya S, Yasutomi M et al (1989) Comparison of surgical therapy and combined irradiation in rectal cancer–first report, effect of irradiation on the tumor. Study Group of Surgical Therapy and Combined Irradiation in Rectal Cancer [in Japanese]. Gan To Kagaku Ryoho 16:3161–3172PubMed

32.

Koda K, Miyazaki M, Sarashina H et al (2003) A randomized controlled trial of postoperative adjuvant immunochemotherapy for colorectal cancer with oral medicines. Int J Oncol 23:165–172PubMed

33.

Saji S, Kajima T, Takao H et al (1983) A study on postoperative long-term continuous immuno-chemotherapy with PSK and 5-FUDS for advanced gastric and colo-rectal cancers [in Japanese]. Gan To Kagaku Ryoho 10:756–762PubMed

34.

Munemoto Y, Iida Y, Abe J et al (2002) Significance of postoperative adjuvant immunochemotherapy after curative resection of colorectal cancers: Association between host or tumor factors and survival. Int J Oncol 20:403–411PubMed

35.

Munemoto Y, Iida Y, Ohata K et al (2004) Significance of postoperative adjuvant immunochemotherapy after curative resection of colorecral cancers: identification of responders incorporating the age factor. Oncol Rep 11:623–635PubMed

36.

Nio Y, Tsubono M, Tseng CC et al (1992) Immunomodulation by orally administered protein-bound polysaccharide PSK in patients with gastrointestinal cancer. Biotherapy 4:117–128CrossRefPubMed

37.

Hayashibe A, Kito H, Taruya E et al (1992) Immunological competence and effect of PSK in patients with gastric cancer and colon cancer: preliminary report [in Japanese]. Nippon Geka Gakkai Zasshi 93:770PubMed

38.

Sugimachi K, Maehara Y, Kusumoto T et al (1995) In vitro reactivity to a protein-bound polysaccharide PSK of peripheral blood lymphocytes from patients with gastrointestinal cancer. Anticancer Res 15:2175–2179PubMed

39.

Shibata M, Nezu T, Kanou H et al (2002) Immunomodulatory effects of low dose cis-Diaminedichloroplatinum (cisplatin) combined with UFT and PSK in patients with advanced colorectal cancer. Cancer Invest 20: 166–173CrossRefPubMed

40.

Alliot C (2004) Adjuvant immunochemotherapy with oral Tegafur/Uracil plus PSK in patients with stage II or III colorectal cancer. Br J Cancer 90:1003–1010CrossRefPubMed

41.

Ohwada S, Ikeya T, Yokomori T et al (2004) Adjuvant immunochemotherapy with oral Tegafur/Uracil plus PSK in patients with stage II or III colorectal cancer: a randomized controlled study. Br J Cancer 90:1003–1010CrossRefPubMed

42.

Saeki Y, Hosokawa O, Yamamichi N (1984) Regression of adenomas in Gardner’s syndrome induced by systemic chemotherapy [in Japanese]. Gan No Rinsho 30:849–854PubMed

43.

Nishizawa R, Fukushima T, Seidou D et al (1987) A case report of rectal cancer with effective Krestin treatment [in Japanese]. Prog Med 7: 855–858

44.

Ishigaki H, Satoh S, Saitoh S et al (1989) An autopsy case of rectal cancer receiving cisplatin at total dose of 3.250 mg and platinum concentrations in autopsy tissue samples [in Japanese]. Gan To Kagaku Ryoho 16: 3805–3808PubMed

45.

Masayoshi U, Ishida H, Kiyomatsu Y et al (1991) A case of rectal carcinoma disappeared by the preoperative radiation [in Japanese]. Nippon Geka Gakkai Zasshi 92:222–224PubMed

46.

Toshino Y, Jojima T, Abe M et al (1992) Case report of lung metastasis from sigmoid colon cancer with effective combination therapy using HCFU and PSK [in Japanese]. Biotherapy 6:1331–1333

47.

Kaneoka S, Nakanishi M, Osawa J et al (1994) A case report of juvenile colon cancer with massive peritoneal dissemination effectively treated by immunochemotherapy [in Japanese]. Biotherapy 8:607–609

48.

Ikeda M, Shigemitsu Y, Era S et al (1997) A case report of a juvenile large bowel cancer [in Japanese]. Iryou 51:367–370

49.

Mukai M, Tokunaga N, Yasuda S et al (2000) Long-term survival after immunochemotherapy for juvenile colon cancer with peritoneal dissemination: a case report. Oncol Rep 7:1343–1347PubMed

50.

Kudo S, Tanaka J, Kashida H et al (2002) Effectiveness of immunochemotherapy with PSK, a protein-bound polysaccharide, in colorectal cancer and changes of tumor marker. Oncol Rep 9:635–638PubMed

51.

Ohwada S, Kawate S, Ikeya T et al (2003) Adjuvant therapy with protein-bound polysaccharide K and tegafur uracil in patients with stage II or III colorectal cancer: randomized, controlled trial. Dis Colon Rectum 46:1060–1068CrossRefPubMed

52.

Ito K, Nakazato H, Koike A et al (2004) Long-term effect of 5-fluorouracil enhanced by intermittent administration of polysaccharide K after curative resection of colon cancer. A randomized controlled trial for 7-year follow-up. Int J Colorectal Dis 19:157–164CrossRefPubMed

53.

Nakazato H, Ichihashi H, Kondo T et al (1986) Clinical results of a randomized controlled trial on the effect of adjuvant immunochemotherapy using Esquinon and Krestin in patients with curatively resected gastric cancer. Cooperative Study Group of Cancer Immunochemotherapy, Tokai Gastrointestinal Oncology Group [in Japanese]. Gan To Kagaku Ryoho 13:308–318PubMed

54.

Takashima S, Kinami Y, Miyazaki I (1988) Clinical effect of postoperative adjuvant immunochemotherapy with the FT-207 suppository and PSK in colorectal cancer patients. Colorectal Cancer Chemotherapy Group in Hokuriku [in Japanese]. Gan To Kagaku Ryoho 15:2229–2236PubMed

55.

Mitomi T, Tsuchiya S, Iijima N et al (1989) Randomized controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum [in Japanese]. Gan To Kagaku Ryoho 16:2241–2249PubMed

56.

Mitomi T, Tsuchiya S, Iijima N et al (1993) Randomized controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer [in Japanese]. Nippon Gan Chiryo Gakkai Shi 28:71–83

57.

Sakamoto J, Teramukai S, Nakazato H et al (2002) Efficacy of adjuvant immunochemotherapy with OK-432 for patients with curatively resected gastric cancer: a meta-analysis of centrally randomized controlled clinical trials. J Immunother 25:405–412CrossRefPubMed

58.

Sakamoto J, Teramukai S, Watanabe Y et al (2001) Meta-analysis of adjuvant immunochemotherapy using OK-432 in patients with resected non-small-cell lung cancer. J Immunother 24:250–256CrossRef

59.

Nakazato H, Koike A, Saji S et al (1994) Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Lancet 343:1122–1126CrossRefPubMed

60.

Hirose K, Zachariae CO, Oppenheim JJ et al (1990) Induction of gene expression and production of immunomodulating cytokines by PSK in human peripheral blood mononuclear cells. Lymphokine Res 9:475–483PubMed

61.

Hayashida Y, Kurimoto S, Yamamoto N (1991) Effect of lymphokine-activated killer cells on human retinoblastoma cells (Y-79) in vitro: enhancement of the activity by a polysaccharide preparation, krestin. Biochem Biophys Res Commun 174:107–114CrossRefPubMed

62.

Kato M, Hirose K, Hakozaki M et al (1995) Induction of gene expression for immunomodulating cytokines in peripheral blood mononuclear cells in response to orally administered PSK, an immunomodulating protein-bound polysaccharide. Cancer Immunol Immunother 40:152–156PubMedCrossRef

63.

Yefenof E, Gafanovitch I, Oron E et al (1995) Prophylactic intervention in radiation-leukemia-virus-induced murine lymphoma by the biological response modifier polysaccharide K. Cancer Immunol Immunother 41:389–396CrossRefPubMed

64.

Algarra I, Collado A, Garrido F (1997) Protein bound polysaccharide PSK abrogates more efficiently experimental metastases derived from H-2 negative than from H-2 positive fibrosarcoma tumor clones. J Exp Clin Cancer Res 16:373–380PubMed

65.

Pedrinaci S, Algarra I, Garrido F (1999) Protein-bound polysaccharide (PSK) induces cytotoxic activity in the NKL human natural killer cell line. Int J Clin Lab Res 29:135–140CrossRefPubMed

66.

Laurie JA, Moertel CG, Fleming TR et al (1989) Surgical adjuvant therapy of large-bowel carcinoma: an evaluation of levamisole and the combination of levamisole and fluorouracil. J Clin Oncol 7:1447–1456PubMed

67.

Kondo T, Sakamoto J, Nakazato H (1991) Alternating immunochemotherapy of advanced gastric carcinoma: a randomized comparison of carbazilquinone and PSK to carbazilquinone in patients with curative gastric resection. Biotherapy 3:287–295CrossRefPubMed

68.

Sakamoto J, Teramukai S, Koike A et al (1996) Prognostic value of preoperative immunosuppressive acidic protein in patients with gastric carcinoma. Findings from three independent clinical trials. Tumor Marker Committee for the Study Group of Immunochemotherapy with PSK for Gastric Cancer. Cancer 77:2206–2212CrossRefPubMed

Titel: Efficacy of adjuvant Immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials
verfasst von: Junichi Sakamoto
Satoshi Morita
Koji Oba
Takanori Matsui
Michiya Kobayashi
Hiroaki Nakazato
Yasuo Ohashi
Meta-Analysis Group of the Japanese Society for Cancer of the Colon Rectum
Publikationsdatum: 01.04.2006
Verlag: Springer-Verlag
Erschienen in: Cancer Immunology, Immunotherapy / Ausgabe 4/2006
Print ISSN: 0340-7004
Elektronische ISSN: 1432-0851
DOI: https://doi.org/10.1007/s00262-005-0054-1

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Efficacy of adjuvant Immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials

Abstract

Neu im Fachgebiet Onkologie

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

Antikörper-Wirkstoff-Konjugat hält solide Tumoren in Schach

Mammakarzinom: Senken Statine das krebsbedingte Sterberisiko?

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

Update Onkologie

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2006

Human T lymphocyte responses against lung cancer induced by recombinant truncated mouse EGFR

Importance of signaling via the IFN-α/β receptor on host cells for the realization of the therapeutic benefits of cyclophosphamide for mice bearing a large MOPC-315 tumor

Adenoviral-mediated transfer of human wild-type p53, GM-CSF and B7-1 genes results in growth suppression and autologous anti-tumor cytotoxicity of multiple myeloma cells in vitro

Melanoma-specific tumor-infiltrating lymphocytes but not circulating melanoma-specific T cells may predict survival in resected advanced-stage melanoma patients

A new dendritic cell vaccine generated with interleukin-3 and interferon-β induces CD8+ T cell responses against NA17-A2 tumor peptide in melanoma patients

Role of tumour-associated N-glycolylated variant of GM3 ganglioside in cancer progression: effect over CD4 expression on T cells

Neu im Fachgebiet Onkologie

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

Antikörper-Wirkstoff-Konjugat hält solide Tumoren in Schach

Mammakarzinom: Senken Statine das krebsbedingte Sterberisiko?

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

Update Onkologie