In contrast, we were able to detect spontaneous tumor specific immune responses after cyclophosph amide treatment in a limited number of patients. More over, low dose cyclophosphamide treatment has also been used in a number of other clinical trials, where it potentially supported the effect of different selleck chemical vaccines and no effect on antigen specific immune responses were observed in a number of different preclin ical studies in mice. Cyclophosphamide, GV1001 and GM CSF treatment were in general well tolerated in this study. There were no adverse events CTC 2 for GV1001 or GM CSF treat ment and the majority of the observed adverse events were related to the injection procedure and injection site reactions. One Grade 3 adverse event was observed in a patient treated with cyclophosphamide, which was reversible.
Therefore Inhibitors,Modulators,Libraries the treatment was much less toxic than other treatments such as sorafenib or other molecular targeting agents. In summary, our study failed to demonstrate significant tumor responses. This might be due to the fact, that in contrast to other GV1001 immunization trials, no clear immune responses have been observed in this study. One possibility is the addition of cyclophosphamide in order to target regulatory T cells or the nature of the disease, although clear T cell responses have been observed in other vaccination Inhibitors,Modulators,Libraries trials. Further studies are needed to analyze the effect of a com bined chemo immunotherapy, which will be interesting in light of recent data, which suggest that Sorafenib, which has become the standard of care for patients with advanced HCC has significant effects Inhibitors,Modulators,Libraries on tumor specific immune responses.
Background In 1890, Ransom described a patient with a carcinoid syndrome and liver metastasis, which was the first report of metastatic neuroendocrine tumor. Radical surgery has been the only available cure for NETs although more than 50% of these tumors are unresectable Inhibitors,Modulators,Libraries at diagnosis. And once Inhibitors,Modulators,Libraries metastasis presents, NET is usually not curable with their clinical courses being diverse from relatively indolent to aggressive. In the case of unresectable metastatic NETs, they has been treated with either local treatment modalities or systemic treatment modalities according to location and burden of metastasis or tumor biology. Systemic treatment including interferon a, somatostatin analogues, and chemotherapy mainly with streptozotocin has been considered palliative and shown only modest antitumor activities.
Therefore, selleck compound local treatment modalities such as palliative surgery, transcatheter arter ial chemoembolization, and radiofrequency ablation have been frequently utilized in the metastatic setting, especially for liver metastasis. Because metastatic recurrent NET is a rare disease, randomized controlled trials have been lacking.