HYBRID HIGH-DOSE BOLUS CONTINUOUS INFUSION INTERLEUKIN-2 IN PATIENTS WITH METASTATIC RENAL-CELL CARCINOMA - A PHASE-II TRIAL OF THE NATIONAL BIOTHERAPY STUDY-GROUP/
Ro. Dillman et al., HYBRID HIGH-DOSE BOLUS CONTINUOUS INFUSION INTERLEUKIN-2 IN PATIENTS WITH METASTATIC RENAL-CELL CARCINOMA - A PHASE-II TRIAL OF THE NATIONAL BIOTHERAPY STUDY-GROUP/, CANCER BIOTHERAPY AND RADIOPHARMACEUTICALS, 12(1), 1997, pp. 5-11
Citations number
25
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging","Pharmacology & Pharmacy
Background: Interleukin-2 (IL-2) is an active agent for the treatment
of renal cell carcinoma. In animal studies polyethylene glycol conjuga
ted (PEG) IL-2 was found to be effective in certain IL-2-resistant mod
els. When bolus/infusion IL-2 was administered to approximate the phar
macokinetics of PEG-IL-2, resistance was also overcome in these models
. Based on these observations, the National Biotherapy Study Group (NB
SG) previously had conducted a pilot study (NBSG 90-01) and then a pha
se I trial off a hybrid regimen of bolus IL-2 followed by continuous I
L-2 (NBSG 91-04). Methods: In the current study, NBSG 92-09, a phase I
I trial was conducted in patients with metastatic renal cell carcinoma
using IL-2 at a dose of 36 MIU/m(2) followed by a 72-hour continuous
infusion of IL-2 at 18 MIU/m(2) per day, so that over 3 days a total o
f 90 MIU/m(2) of IL-2 were delivered; the same amount as previously gi
ven during 5 days of continuous intravenous (IV) IL-2 at 18 MIU/m(2) p
er day. This was repeated every 2 weeks for 2 months, and then monthly
for up to 4 months. Results: Thirty-one patients with a median age of
62 years were enrolled in this trial. During the first 4 biweekly tre
atments, the percentages of planned IL-2 administered were 98% for 31
patients, 99% for 27, 98% for 23, and 99% for 20 patients. Toxicities
were qualitatively the same as those seem with other IL-2 regimens. Du
ring the first 2 months, 4 patients ceased treatment because of rapidl
y progressive disease while 7 patients stopped because of toxicity; 5
of the 7 were >65 years of age. At the time of formal reassessment aft
er 2 months of treatment, 7 additional patients had progressive diseas
e for a treatment failure rate of 55% prior to monthly maintenance the
rapy. There were two partial responses among 22 patients who had measu
rable disease for a response rate of 9%(1 to 29%, 95% CI). Median surv
ival was 10.2 months and failure-free survival (FFS) 3.4 months for th
e entire group. Conclusion: The response rate seen with this regimen i
s similar to those of other schedules of IL-2 requiring more prolonged
hospitalization. This hybrid bolus/continuous infusion IL-2 schedule
appears to be an equally effective and less expensive schedule of IL-2
administration than previously reported inpatient regimens. However i
t is not likely that this regimen is superior to outpatient combinatio
n biotherapy regimens which are currently under investigation.