TY - JOUR
T1 - Subcutaneous interleukin-2 plus interferon alfa-2a in metastatic renal cancer
T2 - An outpatient multicenter trial
AU - Vogelzang, Nicholas J.
AU - Lipton, Allan
AU - Figlin, Robert A.
PY - 1993/1/1
Y1 - 1993/1/1
N2 - Purpose: A prospective multicenter phase II trial was undertaken to define the activity of a low-dose subcutaneous regimen of interleukin-2 (IL-2) and Interferon alfa-2a (IFN) in patients with metastatic renal cancer. Patients and Methods: Between December 1990 and October 1991, 42 patients with metastatic renal cancer who had received no prior immunotherapy were treated with IL-2 (4 × 106 U) days 1 through 4 and IFN (9 × 106 U) day 1 and 4 each week of a 4-week treatment course followed by a 2-week rest period. Maximum duration of therapy was 1 year. Concomitant therapy with acetaminophen, diphenhydramine, and indomethacin was recommended. Treatment was administered on an outpatient basis. Results: With a median follow-up duration of 18 months, responses occurred in five of 42 patients (12%; 95% confidence interval [CI], 2% to 22%). One pathologic complete remission, one surgical complete remission. and three partial remissions occurred. Toxicity was modest, with a symptom complex of rash, fever, anorexia, fatigue, mild weight loss, lymphocytosis, and eosinophilia occurring in 85% to 90% of patients. Renal dysfunction (creatinine > 2 mg/dL) occurred in 19% of patients, while three patients (7%) refused further IL-2 and IFN. No toxic deaths occurred. The median survival duration was 14.5 months. Conclusion: This outpatient low-dose subcutaneous regimen induced mild toxicity, a modest response rate, and an excellent median survival duration in previously untreated patients. Phase III trials are now needed to compare IL-2 plus IFN with IL-2 alone or to various IL-2/ IFN regimens. However, the major task is to identify unique new agents with activity in renal cancer.
AB - Purpose: A prospective multicenter phase II trial was undertaken to define the activity of a low-dose subcutaneous regimen of interleukin-2 (IL-2) and Interferon alfa-2a (IFN) in patients with metastatic renal cancer. Patients and Methods: Between December 1990 and October 1991, 42 patients with metastatic renal cancer who had received no prior immunotherapy were treated with IL-2 (4 × 106 U) days 1 through 4 and IFN (9 × 106 U) day 1 and 4 each week of a 4-week treatment course followed by a 2-week rest period. Maximum duration of therapy was 1 year. Concomitant therapy with acetaminophen, diphenhydramine, and indomethacin was recommended. Treatment was administered on an outpatient basis. Results: With a median follow-up duration of 18 months, responses occurred in five of 42 patients (12%; 95% confidence interval [CI], 2% to 22%). One pathologic complete remission, one surgical complete remission. and three partial remissions occurred. Toxicity was modest, with a symptom complex of rash, fever, anorexia, fatigue, mild weight loss, lymphocytosis, and eosinophilia occurring in 85% to 90% of patients. Renal dysfunction (creatinine > 2 mg/dL) occurred in 19% of patients, while three patients (7%) refused further IL-2 and IFN. No toxic deaths occurred. The median survival duration was 14.5 months. Conclusion: This outpatient low-dose subcutaneous regimen induced mild toxicity, a modest response rate, and an excellent median survival duration in previously untreated patients. Phase III trials are now needed to compare IL-2 plus IFN with IL-2 alone or to various IL-2/ IFN regimens. However, the major task is to identify unique new agents with activity in renal cancer.
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U2 - 10.1200/JCO.1993.11.9.1809
DO - 10.1200/JCO.1993.11.9.1809
M3 - Article
C2 - 8355047
AN - SCOPUS:0027199879
SN - 0732-183X
VL - 11
SP - 1809
EP - 1816
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 9
ER -