ACUTE-PHASE PROTEINS AND RECOMBINANT IL-2 THERAPY - PREDICTION OF RESPONSE AND SURVIVAL IN PATIENTS WITH COLORECTAL-CANCER

Twenty-four patients with metastatic colorectal cancer were treated wi th recombinant IL-2 (rIL-2) by continuous intravenous infusion for 5 d ays (18 x 10(6) U/m(2) per 24 h), followed by three injections of 5-fl uorouracil (600 mg/m(2)) and folinic acid (25mg/m(2)) at weekly interv als. The response to treatment was assessed using standard UICC criter ia (partial or complete response, stasis or progression of disease). T he serum concentrations of the acute phase proteins; C-reactive protei n (CRP), retinol binding protein (RBP), alpha(1)-antitrypsin (alpha(1) -AT), transferrin (TF) and albumin were measured. A response to therap y occurred in the tumours of seven (29%) of the 24 patients (two compl ete and five partial responses). All patients who demonstrated a respo nse to treatment had a serum albumin level of > 37 g/l and a CRP level of less than or equal to 10 mg/l. In contrast, of the 17 patients who did not respond to therapy, 12 (71%) had a serum albumin of less than 37 g/dl and a CRP of greater than 10 mg/l. Examination of the surviva l times of the 12 patients who had a pretreatment serum albumin level of less than 37 g/l revealed that all had died within 12 months of ces sation of therapy. However, 58% of patients with pretreatment serum al bumin levels of greater than 37 g/l survived for longer than 12 months . These results have shown that (i) patients who respond to rIL-2-base d therapy and (ii) those patients who have prolonged survival times, c an be identified by pretreatment measurement of serum levels of acute phase proteins.