Chemoimmunotherapy for advanced ovarian carcinoma with adriamycin-cyclophosphamide ± BCG: Early report of a Southwest Oncology Group study

The preliminary results of this Southwest Oncology Group study of chemotherapy versus chemotherapy + adjuvant BCG immunotherapy in advanced ovarian cancer patients suggests advantage for the A-C+BCG treatment with respect to the partial response rate, remission duration, and survival. The mechanism by with BCG apparently augments the effect of A-C remains obscure but conceivably could be a local or regional effect. Based on our in vitro studies we speculate that regional BCG sacrification might alter the function of intraperitoneal macrophages and thereby reduce the proliferation of clonogenic tumor cells. Final validation of the efficacy of BCH immunotherapy in the setting of adriamycin-cyclophosphamide therapy will depend upon 1-2 more years of patient accrual and observation as well as complete histologic review of all pathologic specimens for patients entered on this trial. If this study remains positive, it will provide an important newapproach to the treatment of patients with recurrent or stages III and IV disease. The addition of adjuant nonspecific immunostimulant therapy to an effective combination chemotherapy regimen will hopefully offer the possibility of improved 5-year survival rates. This relatively well-tolerated chemoimmunotherapy regimen could be used to treat earlier stage disease where there is a high risk of relapse despite aggressive surgery and adjuvant radiation therapy and/or-single agent chemotherapy.