Anti-PD-1 Immunotherapy and Bee Venom for Relapsed and Refractory Liposarcoma: A Case Report

Abstract

Cancer immunotherapies, including immune checkpoint inhibitors, elicit long-term clinical responses but many cancer patients do not respond. Intensive efforts are therefore underway to identify additional immune pathways that may be modulated to enhance the efficacy of existing immunotherapies. Bee venom strongly stimulates the immune system, and is used as a complementary therapy to treat cancer pain in patients with advanced tumors in China. Bee venom contains several allergenic protease inhibitors and peptides. It triggers hypersensitivity reactions; that is, it is an immune system agonist. The generation of a spontaneous T cell response against tumor-associated antigens requires innate immune activation; this drives type I interferon production. We report a patient with a relapsed and refractory liposarcoma who had undergone several operations, chemotherapies, and radiotherapies. The tumor was large. The patient had attained the maximum radiation exposure dose. The tumor was resistant to chemotherapy and was infiltrating the pericardium, lungs, and diaphragm. The patient was a poor candidate for resection. He thus received apitherapy (a combination of bee venom and acupuncture) to control pain; then apatinib (an anti-angiogenic drug) was given to inhibit tumor growth but was terminated early because the patient could not tolerate the side effects. Subsequently, a programmed death 1 inhibitor was combined with apitherapy. Bee venom served as an innate immune system agonist promoting immune cell priming and recruitment in the tumor microenvironment. The patient was finally able to undergo radical liposarcoma resection, and no evidence of recurrence was found at re-examination 16 months after surgery.

A Preliminary Investigation on the Possibility of Developing a Cancer Vaccine Using Snake Venom Components

“…Zhang & Chen (2017) [39] confirm that melittin exerts an anti-angiogenesis effect on lung cancer cells in vitro and in vivo by suppressing the secretion of the vascular endothelial growth factor protein. Furthermore, bee venom is used in China for patients with advanced tumours [40]. In this study, we investigated the possibility that people who have been a victim of a snake bite and survived may gain prophylaxis for developing cancer as observed and predicted in Figure 5 and Figure 6.…”

Effect of Combined Bee Venom Acupuncture and NSAID Treatment for Non-Specific Chronic Neck Pain: A Randomized, Assessor-Blinded, Pilot Clinical Trial

“…For this reason, a safe and long-term effective treatment that can complement the NSAIDs is needed. In East Asia, BVA combined with conventional medication, including NSAIDs, has been used to treat cancer-related pain [ 28 ] and low back pain [ 29 ], and especially, its clinical effect for NCNP has been well studied [ 13 , 19 ]. Future clinical research on the efficacy of combining BVA with a tapered dose of NSAIDs will be a significant contribution in this field.…”