Invasive Bladder Cancer after Cyclophosphamide Administration for Nephrotic Syndrome : A Case Report

We report a case of invasive bladder cancer after cyclophosphamide administration for nephrotic syndrome, and briefly discuss the association of bladder cancer and cyclophosphamide.　　 A 6-year-old boy, who was diagnosed as having nephrotic syndrome, was treated with oral administration of prednisolone and cyclophosphamide for 4 years, receiving a total dose of 49.5 g cyclophosphamide. At age 27, a gross hematuria with bloody clots appeared and he presented with postrenal renal failure. He underwent a radical cystourethrectomy and ileal conduit for stage a pT3a pN0 M0 transitional cell carcinoma of the bladder. He was not given any adjuvant treatments because of his renal insufficiency, and he died from the disease 14 months after radical surgery

Gene Therapy for Murine Renal Cell Carcinoma Using Genetically Engineered Tumor Cells to Secrete lnterleukin-12

To determine the possibility of gene therapy for renal cell carcinoma (RCC) using interleukin- 12 (IL-12), we prepared genetically engineered murine RCC cells (Renca) which secrete IL-12 and evaluated the usefulness of these cells as a tumor vaccine. The IL-12 gene was transduced using MFG retroviral vector. The in vitro characteristics of transfectants―i.e., cell proliferation and expression of surface antigens―were then examined. In vivo tumorigenicity was assessed by subcutaneously injecting each type of cell in syngenic BALB/c mice. For the challenge experiments, the mice rejecting previously injected Renca IL-12 cells were rechallenged with parental cells. To determine the antitumor effect at remote sites, mice were injected with parental cells into the left flank, and then either Renca IL-12 or parental cells were inoculated into the opposite site on day 0 or 1. The transfected cells can secrete 146.7ng/ml/10⁶cells/48 hr of IL-12, as confirmed here by bioassay. The in vitro characteristics of the transfectants were not altered, but in vivo tumorigenicity was significantly reduced. Of the 21 mice that rejected Renca IL-12 cells, 9 failed to develop tumors after the challenge with parental cells. In the mice treated with Renca IL-12 as a vaccine, both number and tumor volume of the mice that developed tumors at remote sites were reduced. IL-12 secreting Renca cells conferred both protective immunity to parental cells and delay of tumor growth at remote sites, indicating that IL-12 secreting Renca cells are a feasible candidate for use in gene therapy of RCC.This study was supported in part by Grants-in-Aid from the Ministry of Education, Science, Sports and Culture of Japan (nos. 07671731, 08671816, and 10671475)

Anti-Tumor Effect of Murine Renal Cell Carcinoma Cells Genetically Modified to Express B7-1 Combined with Cytokine Secreting Fibroblasts

Recently, many experiments have shown that the expression of the costimulatory molecule B7-1 on tumor cells can induce tumor-specific immunity. These results suggest that tumor cells modified to express costimulatory molecules can be used as a potential tumor vaccine. For this purpose, we transduced B7-1 gene into renal adenocarcinoma cells of spontaneous origin (Renca) in BALB/c mouse using the retroviral vector system. Our results indicated that approximately 60% of cells expressed B7-1 gene product using the retroviral vector system, and that B7-1 transduction did not affect the expression of MHC molecules on tumor cells nor the in vitro growth rate of tumor cells, but only in vivo tumorigenicity. As for the antitumor effect on the remote site, there were no significant differences among parental Renca, Renca lac Z and Renca B7-1 sublines, although tumors grew a little more slowly in the mice injected with Renca B7-1 cells as a vaccine. Even if the growth of tumors was significantly delayed in the mice treated by Renca B7-1 as a vaccine combined with the injection of BALB/c3T3 IL-12 near to the tumor on the same or following day, no significant antitumor effects were observed when the Renca B7-1 cells were injected as a vaccine compared with cytokines near the vaccine site. These results indicated that B7-1 gene transduction can decrease the tumorigenicity of murine renal cell carcinoma cells, but fails to induce sufficient antitumor response when it is used as a tumor vaccine. It is necessary to develop immunogenicity, by such menas as irradiation or a combination of appropriate cytokines, to stimulate effective tumor immunity in a therapeutic setting.This study was supported in part by grants-in-aid from the Ministry of Education, Science, Sports and Culture, Japan (grant no. 08671816 and no. 10671475)