Shahab Abdessalam

Combination Therapy with Anti–CTL Antigen-4 and Anti-4-1BB Antibodies Enhances Cancer Immunity and Reduces Autoimmunity

The majority of cancer antigens identified thus far have limited expression in normal tissues. It has been suggested that autoimmune disease is a necessary price for cancer immunity. This notion is supported by a recent clinical trial involving an anti-CTL antigen-4 (CTLA-4) antibody that showed significant clinical responses but severe autoimmune diseases in melanoma patients. To selectively modulate cancer immunity and autoimmunity, we used anti-CTLA-4 and anti-4-1BB antibodies to treat mice with a preexisting cancer, MC38. The combination of the two antibodies led to CD8 T-cell-mediated rejection of large established MC38 tumors and long-lasting immunity to the same tumor cells, although the same regimen was not effective for B16 melanoma. More importantly, whereas individual antibodies induced inflammation and autoimmune manifestations, combination therapy increased cancer immunity while reducing autoimmunity. The reduction of autoimmune effects correlates with an increased function of regulatory T cells. Our results suggest a novel approach to simultaneously enhance cancer immunity and reduce autoimmunity.

Cost-effectiveness of sentinel lymph node biopsy in thin melanomas.

BACKGROUND Consideration of sentinel lymph node biopsy (SLNB) is recommended for thin melanomas with poor prognostic features; however, few metastases are identified. The purpose of this study was to assess the cost effectiveness of SLNB in this population. METHODS The prospective melanoma database was reviewed to identify patients with melanomas <1.2 mm thick who had undergone SLNB. Physician and hospital charges were collected from the appropriate billing department. RESULTS A total of 138 patients were identified over an 8-year period (1994-2002). Two patients with positive SLNs were identified (1.4%), one with a melanoma <1 mm thick. Patient charges for SLNB ranged from

Patterns of recurrence after sentinel lymph node biopsy for breast cancer.

10,096 to

Effective Use of the Air Ambulance for Pediatric Trauma

15,223 US dollars, compared with

Selective analysis of the sentinel node in breast cancer

1000 to

Pilot Study Using a Humanized CC49 Monoclonal Antibody (HuCC49°CH2) to Localize Recurrent Colorectal Carcinoma

1740 US dollars for wide excision as an outpatient. Using these charges, the cost to identify a single positive SLN would be between

Undescended testes: Does age at orchiopexy affect survival of the testis?

696,600 and

Castleman disease: surgical cure in pediatric patients

1,051,100 US dollars. The cost for wide excision would be between

Identifying strategies to decrease infectious complications of gastroschisis repair

69,000 and

Stiff‐Person Syndrome: A Rare Presentation for Breast Cancer

120,100 US dollars. Assuming that all patients with a positive SLN would die of melanoma, the cost per life saved would be