Intraoperative Immuntherapie mit dem trifunktionalen Antikörper Catumaxomab bei Patienten mit fortgeschrittenem Magen-, Colon- und Pankreaskarzinom: Ergebnisse einer Phase I Pilotstudie

Author: M. Jäger ; K. Bartelheim ; M. Ströhlein ; O. Schemanski ; H. Lindhofer ; M. M. Heiss

Background: The prognosis of advanced Gi-tract cancer is significantly influenced by intraperitoneal tumor cell dissemination, which is followed by tumor recurrence and peritoneal carcinomatosis. The trifunctional antibody Catumaxomab demonstrated extended tumor cell destruction and clinical efficacy in patients with peritoneal carcinomatosis and malignant ascites. In order to evaluate the concept of i. p. Catumaxomab treatment in patients with major tumor resection, intraoperative application directly after tumor resection was investigated. Aims of study were feasibility, tolerability and first data of clinical efficacy. Patients and methods: patients with GI-tract cancer received 5 increasing dosages intraperitoneally directly after tumor resection and on day 7, 10, 13, 16 after surgery. I. p. tumor destruction was sreened by immunohistochemical analysis of lavage samples. All patients had prospective follow up. Results: 12 patients (8 gastric-, 3 pancreatic-, 1 colon cancer) were included. Intraoperative treatment was tolerated up to 20 µg without dose limiting toxicities. 1st to 4th postoperative infusions were 10–20–50–150 µg according to former studies. I. p. tumor cells decreased in 5/8 evaluable patients 24 h after intraoperative treatment. Follow-up showed no intraperitoneal tumor recurrence (mean follow-up 12 months). 2 patients with pancreatic carcinoma died from distant metastasis. 2 patients had non-cancer related deatch. Conclusion: Intraoperative immunotherapy with trifunctional antibodies is technically feasible and safe up to 20 µg even in patients with extended tumor surgery. This novel concept offers promising opportunities to prevent tumor recurrence and peritoneal carcinomatosis in GI-tract cancer.

Chirurgisches Forum 2007

Einsatz von Neo-Hepatozyten zur Therapie des fibrotischen Leberschadens

Author: Christian Eipel ; M. Brulport ; A. K. Nüssler ; B. Vollmar ; K. Sievert ; J. G. Hengstler

Hepatocyte transplantation has been successful in many animal models of acute liver failure. In contrast, only few clinical attempts have been made, mainly because of the lack of a reliable source of liver cells. Transplantation of human stem or precursor cells may represent an alternative technique. Herein, we evaluated whether transplantation of Neo-Hepatocytes, i. e. hepatocyte-like cells differentiated from blood monocytes, could sustain function and recovery of fibrotic liver tissue. A single intrahepatic transplantation of Neo-Hepatocytes did not support liver function (urea and ammonia plasma levels) as well as liver recovery (aspartate aminotransferase plasma level) in case of CCl4-induced liver fibrosis.

GIT Spezial Separation

Automatic calibration quantification using HPLC

Author: Bitterle, Thomas

The Summit HPLC from Dionex in combination with Chromeleon software and the autosampler ASI 100(T) offers the possibility of carrying out a (DIN-compliant) quantification by automatic calibration using variable volumes of a standardThe automatic injection of these volumes omits weighing and pipetting work and makes it possible to monitor measuring uncertainty by means of special system suitability tests in routine operations.In the investigated range, this method gave homogeneous variances.Unfortunately, this advantage of the autosampler is not yet fully supported by the Chromeleon software because the the calibration function cannot evaluate with prognosis intervals.Future versions of the software should support this.

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