Clinical benefit of non-toxic therapy in patients with advanced cancer (opinion).

It has been widely recognized that chemotherapy of cancer has profound toxic side-effects and suffers limitations in efficacy but, as yet, no solution has been found to this conflict. Consequently, many patients with advanced cancer desire treatment by less toxic therapies even if the technique is not established as a conventional cancer therapy. Thus the establishment of less toxic therapies should be considered as a tentative requirement in clinical practice. Adoptive immunotherapy is one such therapy which has enjoyed some popularity in Japan. Clinical experience accumulated over the last 15 years indicates benefits to be gained from the therapy. In 1998, the Ministry of Health, Labor and Welfare of Japan (MHLW) approved portions of adoptive immunotherapy practices in their definition of highly-advanced medical technology. In April 1999, we established a private out-patient clinic specializing in adoptive immunotherapy; this clinic has administered 200 infusions of activated lymphocytes a month. Out of the 188 patients treated, we evaluated the tumors of 57 cases (2 CR, 4 PR, 20 SD and 31 PD). The response rate was 11%. It is noteworthy that in 11 of the 20 SD patients, the disease remained stable for more than six months. The follow-up periods for these 11 patients ranged from 11 to 24 months. During this period tumor progressed in 2, but the remaining 9 were still alive and without noticeable disease progression. Our present experience of adoptive immunotherapy administered to a large number of patients indicates that this non-toxic therapy has some beneficial role for the treatment of refractory cancer.