TREATMENT OF CARCINOID-SYNDROME WITH RECOMBINANT INTERFERON-ALPHA-2A

The prognosis and the quality of life of patients with carcinoid tumor s is related either to symptoms from the substances secreted or to pro gressive tumor growth. Medical treatment with cytotoxic agents is of m arginal value for increasing life expectancy and reducing clinical sym ptoms. Recent studies with interferon have shown interesting results. In the present investigation, 22 patients with carcinoid tumors and sy ndrome were treated with recombinant interferon alpha-2a (r-IFN alpha- 2a) at the dose of 6 x 10(6) IU intramuscularly daily for 8 weeks and three times weekly thereafter. The primary tumor was localized in the foregut (n = 11), midgut (n = 7), hindgut (n = 1), and unknown site (n = 3). Most cases had liver metastasis. Seventeen patients had elevate d 5-hydroxyindoloacetic acid (5-HIAA) excretion and 5 had flushing and /or diarrhea as the only clinical manifestation. Six cases presented a complete syndrome (flushing, diarrhea and 5-HIAA excretion). Control of symptoms was obtained in 80% and a 5-HIAA level reduction in 58% of the patients. The interferon treatment was more effective for control of the carcinoid syndrome than for control of tumor growth. The treat ment was well tolerated and fever, myalgia, anorexia and fatigue were the most frequent side-effects.