Efficacy
Bacterial immunotherapy is routinely used in the treatment of bladder cancer and has previously been succesfully used for other cancer types as well as in other mammalian species.
Bladder cancer
The bacterial immunotherapeutic BCG (Bacille Calmette-Guérin), has become the method of choice in the treatment of high-risk non-muscle-invasive bladder cancer (NMIBC).
A BCG treatment comprises injecting weakened bacteria in the bladder in order to trigger an immune response against both these bacteria as well as cancer cells.
Bladder cancer is the 7th most prevalent cancer type and NMIBC constitutes 75%-80% of all newly presented bladder cancer cases. At diagnosis NMIBC can occur in different stages and treatments and cure-rates will vary depending on the stage of the disease when therapy is initiated. BCG is the treatment of choice for high risk NMIBC patients.
In retrospective evaluations cited by the European Association of Urology a complete response rate of 72−93% was achieved with BCG (although up to 50% of complete responders might eventually show recurrence). BCG maintenance treatment is reported to reduce the risk of progression by 27%.
OK-432
OK-432 is a Japanese bacterial immunotherapy product that is approved for the treatment of (paediatric) lymphangiomas (benign malformations of the lymphatic system). In a recent European study over 85% of patients were found to have a good or excellent response. In multiple cancer types OK-432 has also been shown to result in a meaningful surival benefit.
Other cancer types
Bacterial immunotherapy has been used successfully as early as the 1890’s (see history).
More recently, good results have been generated in multiple cancer types. These include:
- Melanoma
- Osteosarcoma
- Prostate
- Colon cancer
- Lymphoma
Other species
Examples of the successful use of bacterial immunotherapies in the treatment of a variety of animal species & cancer types include:
- Dogs - osteosarcoma
- Horses - osteosarcoma
- Mice - pancreatic cancer
- Rats - multiple cancer types
Conclusions
Cited publications (see references below) provide very strong evidence of the potential efficacy of bacterial immunotherapies in cancer types beyond bladder cancer (although not all previous studies have reported positive outcomes); as the leading scientific journal Science recently concluded; "injections of microbes may be alternative to chemotherapy and radiation".
Both successful and less successful tests have been based on a variety of microbial strains, a variety of ways of administering them and both are probably important success factors. One of the key objectives of BACTherapy.org is to, based on our current understanding, define the optimal use of bacterial immunotherapy and test these protocols in clinical trials.
- Urology Care Foundation: what is Non-Muscle Invasive Bladder Cancer?
- American Cancer Society: 2022 Cancer facts and figures
- Mayo Clinic: high-risk nonmuscle invasive bladder cancer
- Cancer Research UK: non muscle invasive bladder cancer staging
- Medscape: Bacillus Calmette-Guérin Immunotherapy for Bladder Cancer Overview of BCG Immunotherapy
- Cancer Research UK: BCG into the bladder
- BCG Treatment: What It Is, Procedure & Side Effects (clevelandclinic.org)
- Non-muscle-invasive Bladder Cancer - DISEASE MANAGEMENT - Uroweb
- Morton DL, Eilber FR, Holmes EC, Hunt JS, Ketcham AS, Silverstein MJ, Sparks FC. BCG immunotherapy of malignant melanoma: summary of a seven-year experience. Ann Surg. 1974 Oct;180(4):635-43.
- Lardone RD, Chan AA, Lee AF, Foshag LJ, Faries MB, Sieling PA, Lee DJ. Mycobacterium bovis Bacillus Calmette-Guérin Alters Melanoma Microenvironment Favoring Antitumor T Cell Responses and Improving M2 Macrophage Function. Front Immunol. 2017 Aug 11;8:965.
- Yang J, Jones MS, Ramos RI, Chan AA, Lee AF, Foshag LJ, Sieling PA, Faries MB, Lee DJ. Insights into Local Tumor Microenvironment Immune Factors Associated with Regression of Cutaneous Melanoma Metastases by Mycobacterium bovis Bacille Calmette-Guérin. Front Oncol. 2017 Apr 5;7:61.
- Mukherjee N, Julián E, Torrelles JB, Svatek RS. Effects of Mycobacterium bovis Calmette et Guérin (BCG) in oncotherapy: Bladder cancer and beyond. Vaccine. 2021 Dec 8
- Kremenovic, M, Schenk, M, Lee, DJ, Clinical and molecular insights into BCG immunotherapy for melanoma (Review). J Intern Med 2020; 288: 625- 640.
- Benitez, M.L.R., Bender, C., Oliveira, T.L. et al. Mycobacterium bovis BCG in metastatic melanoma therapy. Appl Microbiol Biotechnol 103, 7903-7916 (2019).
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- Chen, Y., Xu, S., Xu, M., & Yu, X. (2015). Postoperative infection and survival in osteosarcoma patients: Reconsideration of immunotherapy for osteosarcoma. Molecular and Clinical Oncology, 3, 495-500.
- Adjuvant bacillus Calmette-Guérin therapy in non-Hodgkin's malignant lymphomas: long-term results of a randomized trial in a single institution. Journal of Clinical Oncology 8, no. 4 (April 01, 1990) 608-14.
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- Watanabe Y. Clinical value of immunotherapy for lung cancer by the streptococcal preparation OK-432. Cancer. 1984 Jan 15;53(2):248-53. doi: 10.1002/1097-0142(19840115)53:2<248::aid-cncr2820530211>3.0.co;2-g. PMID: 6690008.
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- Donald L. Lamm, Alvaro Morales, A BCG success story: From prevention of tuberculosis to optimal bladder cancer treatment, Vaccine, Volume 39, Issue 50, 2021, Pages 7308-7318, ISSN 0264-410X.