The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 362-368, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Intralesional BCG immunotherapy of pulmonary tumors
EC Holmes, KP Ramming, ME Bein, WF Coulson and CD Callery
A new method of baccile Calmette Guerin (BCG) immunotherapy has been
evaluated in 25 patients with lung cancer. This technique involves the
direct intratumor injection of BCG in patients with pulmonary tumors. Four
patients underwent transbronchoscopic injections of tumor, with significant
resolution of tumor in three. Twenty-one patients underwent percutaneous
injection with the aid of fluoroscopic imaging. Twenty of these 21
underwent pulmonary resection. Toxicity was limited to fever and malaise.
The severity of this toxicity was closely related to the magnitude of
reactivity to PPD. There were no intraoperative or postoperative
complications occasioned by BCG injection. The histologic features were
characterized by granulomatous inflammatory reactions in the tumors and the
regional lymph nodes. These histologic findings are identical to those seen
in animal tumor models in which potent systemic antitumor immunity is
induced. BCG intratumor injection is technically feasible and safe, and it
is appropriate to begin phase 2 and phase 3 clinical trials.