1352PACTIVE PALLIATION AND NEW TREATMENT STRATEGIES FOR MALIGNANT ASCITES USING KM-CART

ABSTRACT Objective: To improve the symptoms of refractory ascites, we have developed a novel cell-free and concentrated ascites reinfusion therapy (KM-CART). KM-CART is easier to use and can be applied for massive malignant ascites. The effectiveness of KM-CART in alleviating symptoms, and the application of cancer cells recovered by KM-CART in personalized medicine are hereby reported. Methods: A total of 1426 patients, including 268 ovarian cancer, 203 gastric cancer, 190 pancreatic cancer, 186 colon cancer, and 579 patients with other disorders, underwent KM-CART between February 2009 and March 2014. It is performed by removing the entire volume of ascitic fluid and administering the recovered autologous proteins into blood vessels by infusion. In all 87 patients for whom a questionnaire survey could be conducted on both the day before and the day after KM-CART, symptom scores improved for 10 items, including abdominal fullness, respiratory discomfort, decreased appetite and gait impairment. Results: Ascitic fluid was removed to the greatest extent possible (0.8–27.0 L; mean, 6.7 L), and removal took 5 -240 min (mean, 68 min). The mean processing rate was 10.5 min/L, and 570 mL of filtered concentrate was created. Side effects consisted of only mild fever, with no serious side effects observed. Due to alleviation of edema, mean lower leg circumference also decreased by 2.8 cm, indicating the effectiveness of KM-CART in improving the ADL of patients. In addition, some patients resumed chemotherapy as a result of regaining the motivation to fight disease. These patients were able to transition to their homes over the long-term. Furthermore, over 2.4x105 cancer cells were recovered from the membrane filter washing fluid in each of 14 patients, and these cells were able to be used for dendritic cell (DC) vaccine therapy. Moreover, active proliferation of cancer cells was observed on day 8. Conclusion: The KM-CART system was considered easy to use and very safe, and the recovery of large volumes of autologous proteins was thought to have improved general status, nutrition, and immune status, as well as subjective symptoms. In addition, the recovered cancer cells were able to be used for drug sensitivity tests and immune cell therapy, indicating the potential for new treatment strategies for malignant ascites in the future. Disclosure: All authors have declared no conflicts of interest.