A 65-year-old male; was a heavy smoker from 15 or 16 to 42 years old and did not have relevant co-morbidities. When he was 58 years old, he underwent a left nephrectomy for the occasional detection of the absence of the left urinary duct. On 5 May 2010, he underwent subtotal esophagectomy with intra-thoracic esophago-plastic surgery; post-operative histology showed adeno-carcinoma of the esophageal–gastric junction, intestinal type by Lauren’s classification. pT2 N0 M0 was the post-operative TNM classification, and cells were HER2 negative. He did not receive any adjuvant therapy. This patient remained disease-free until September 2016, when he went to an emergency department because of heavy abdominal cramps. On this occasion, no pathological signs were ascertained by clinical-radiological assessment, and the patient was discharged without symptoms following anti-inflammatory and anti-spastic therapy. Two months later (in November), the same signs and sialorrhoea occurred; again, he went to the same emergency department, where WB CT showed pelvic ascites and mesenteric fat thickness with small nodules suspected for peritoneal metastases. This diagnosis was confirmed at the National Institute of Cancer in Milan, where the patient was sent for consultation. From 24 November 2016 to 1 February 2017, he received four cycles of 2000/sqm/day capecitabine given orally plus 130 mg/sqm oxaliplatin by i.v. infusion (the Xelox regimen) with complete response (CR); after that, on 1 April 2017, he started maintenance cyclic IT. This patient was disease-free at the last clinical-radiological assessment on 20 May 2019. To date, 35 months from the diagnosis of metastases, he is doing well.\nThe median OS of gastrointestinal cancer patients with moderate metastatic peritoneal ascites was reported to be 9.6 and 13.5 months [,].\nDuring IT in all four cases, the mean basal values of IL-2 increased. In patients 4 and 2, the difference was significant (** p = 0.046 and * p = 0.049, respectively) or close to significant (** p = 0.083). In patient 1, it was close to significant (* p = 0.061 and ** p = 0.083). The mean total number of lymphocytes decreased in two of the four cases. The difference was close to significant in patients 1 (* p = 0.076, ** p = 0.083) and 4 (* p = 0.079, ** p = 0.083). Accordingly, CD3+, CD4+, and NK basal values decreased during IT in three (75%) of the four examined patients. In particular, in contrast to NK, for which no significant difference occurred, the difference in CD3+ was significant (* p = 0.040) or close to significant (* p = 0.083) in patient 1 and close to significant (** p = 0.088) in patient 4. The difference in CD4+ was close to significant in both patients 1 (* p = 0.053, ** p = 0.083) and 3 (** p = 0.083). Basal VEGF, IL-12, and CD19+ values decreased in three (75%) patients. The difference in VEFG was close to significant (** p = 0.083) in patients 1 and 3. IL-12 was significant (* p = 0.040) or close to significant (** p = 0.083) in patient 2 and it was close to significant (** p = 0.083) in patient 1. In patients 1 (p = 0.063, ** p = 0.083) and 4 (* p = 0.071, ** p = 0.077), the difference in CD19+ was close to significant (). No significance was found for IL-6. An increase in three patients with only one close to significant was found for IL-10 and IL-2R. Conflicting results were obtained for CD8+; Treg; CD4+45RO; IL-1R; TNF alpha; TGF beta1; FGF; EGF; IGF1; and IL-1, IL-8, and CMP1 inflammatory cytokines (see ).
On 17 December 2007, a 46-year-old female underwent a radical left mastectomy; post-operative histology showed an infiltrating ductal carcinoma with microscopic lesions of ductal carcinoma in situ.\npT2 N3a (14/28) M1 was the post-operative TNM classification, G3, ER+ (90%) Pr+ (90%), Ki67 40%, and HER2 negative. The post-operative work-up, BS and WB CT showed two metastatic lesions involving the left iliac crest and pubic symphysis, respectively, with elevated serum TPA values. From 9 January 2008 to 31 July 2008, she received salvage chemotherapy with six cycles of 5-fluorouracil-epirubicin-cyclophosphamide (FEC) (600/60/600 mg/sqm on days 1 and 28) followed by four cycles of docetaxel (80 mg/sqm every 21 days). From 1 August 2008 to 2 March 2009, she was continuously given 1 mg anastrozole pills (one pill/day). On 2 March 2009, she was recruited for a pilot study, which we have more times reported [,,,], that applied cycles of IT with beta- interferon and interleukin-2 in addition to continuous conventional salvage hormone-therapy. From April to June 2010, clinical examination, bone scanning, and subsequent abdominal CT showed a complete clinical radiological response with normal values of the serum CEA-TPA-CA15.3 tumor marker panel. To date, these normal values have been maintained during intensive post-operative monitoring. In 2015 and 2016, IT cycles were interrupted for four months; in 2017, 2018, and 2019, both IT and concomitant hormone-therapy were interrupted for 7, 6, and 6 months, respectively.\nOccasionally, metastatic breast cancer patients have been reported with more than a 10-year CR following conventional therapy []. However, these studies had relatively poor clinical-radiological documentation [,].