INTRACAVITARY THERAPY OF NEOPLASTIC EFFUSIONS WITH CYTOKINES - COMPARISON AMONG INTERFERON-ALPHA, INTERFERON-BETA AND INTERLEUKIN-2

Preliminary studies have suggested that the intracavitary administrati on of cytokines may represent a new effective palliative therapy of ma lignant effusions. To define further the therapeutic role of cytokines in the treatment of neoplastic fluid accumulation, 70 cancer patients with pleural, pericardial or peritoneal cytologically proven neoplast ic effusions were randomized to receive intracavitary cycles with inte rleukin-2 (IL-2; 6x10(6) IU), interferon (IFN alpha; 2 x 10(7) U) or I FN beta (6 x 10(6) U) every week for 2 or 3 weeks. A clinical control of fluid accumulation was obtained in 39/70 (56%) patients. In patient s with mesothelioma, the response rate was significantly higher with I L-2 than with IFN alpha or -beta, while there was no difference in pat ients with tumors other than mesothelioma. Moreover, the duration of t he period during which drainage was not required was significantly lon ger in patients treated with Il-2 than in the other groups. Toxicity w as low in all patients. According to preliminary data, this study demo nstrates that intracavitary administration of cytokines, including IL- 2, IFN alpha and -beta, is a new well-tolerated palliative therapy for malignant effusions, with an efficacy substantially comparable to tha t described with the most commonly used treatments with tetracyclines or cytostatic agents.