Subcutaneous interleukin-2 and interferon-alpha in metastatic renal cell carcinoma: results of a French regional experience in Languedoc

Subcutaneous interleukin-2 and interferon-alpha in metastatic renal cell carcinoma: results of a French regional experience in Languedoc

To assess the efficacy and toxicity of an immunotherapy regimen combining subcutaneous (SC) interleukin-2 (IL-2) and interferon-alpha (IFN) in patients with metastatic renal cell carcinoma (MRCC). The present study included 86 patients with MRCC. Data on treatment toxicity and efficacy (responses ra...

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Bibliographic Details
Published in:American journal of clinical oncology Vol. 29; no. 2; p. 148
Main Authors: Culine, Stéphane, Iborra, François, Mottet, Nicolas, Avancès, Christophe, de Graeve, Bertrand, Volpé, Pascal, Vignoud, Jacques, Bringer, Jean-Pierre, Marroncle, Michel, Le Pellec, Loïc, Ayuso, Didier, Jansen, Eric, Faix, Antoine, Rebillard, Xavier
Format: Journal Article
Language:English
Published: United States 01-04-2006
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Renal Cell - drug therapy
Carcinoma, Renal Cell - pathology
Female
France
Humans
Immunotherapy
Injections, Subcutaneous
Interferon-alpha - administration & dosage
Interleukin-2 - administration & dosage
Kidney Neoplasms - drug therapy
Kidney Neoplasms - pathology
Male
Middle Aged
Neoplasm Metastasis
Treatment Outcome
France
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Summary:To assess the efficacy and toxicity of an immunotherapy regimen combining subcutaneous (SC) interleukin-2 (IL-2) and interferon-alpha (IFN) in patients with metastatic renal cell carcinoma (MRCC). The present study included 86 patients with MRCC. Data on treatment toxicity and efficacy (responses rates and overall survival) were collected on a hospital database. Treatment consisted of 6-week cycles repeated every 2 months for a maximum of 3 cycles. Each cycle included SC IL-2 20 x 10 MIU/m2 3 times/wk on weeks 1 and 4; 5 x 10 MIU/m2 3 times/wk on weeks 2, 3, 5, and 6, in combination with IFN 6 x 10 MIU/m2 once weekly on weeks 1 and 4; and 3 times/wk on weeks 2, 3, 5, and 6. Seventy (82%) and 71 (83%) patients received more than 80% of the planned doses of IL-2 and IFN during the first cycle, respectively. Ten patients had to stop therapy before the end of the first cycle because of excessive toxicity (7 patients) or rapidly progressive disease (3 patients). Only 17 (28%) proceeded to the second cycle. Main toxicities included fever and asthenia in 86 (100%) patients, nausea/emesis in 83 (96%) patients, skin disorders in 69 (80%) patients, hypotension in 56 (65%) patients, and diarrhea in 50 (58%) patients. Sixty-seven (78%) patients developed at least one episode of grade 3 toxicity. Objective responses were observed in 13 patients, including 4 complete and 9 partial responses (15%; 95% confidence interval, 9.5-20.5%). After a median follow-up of 45 months, the median time to progression was 4 months (range, 1-41) and the median survival was 14 months (range, 1-89). Only a small subset of patients with MRCC is likely to benefit from treatment with IL-2 and IFN. As toxicity is significant, the refinement of predictive variables for sensitivity to immunotherapy is mandatory.
ISSN:1537-453X
DOI:10.1097/01.coc.0000203753.74851.d5