High dose inhalation interleukin-2 therapy for lung metastases in patientswith malignant melanoma

BACKGROUND. The lungs are a frequent site of metastasis in patients with me lanoma, and this may cause respiratory problems in the terminal phase of th e illness. Inhalation interleukin (IL)-2 therapy to the lung has been pilot ed and appears to be well tolerated. METHODS, Twenty-seven patients were treated with single agent dacarbazine a nd concurrent high dose inhalation IL-2 36 million IU per day). The patient s previously had progressed on chemotherapy, predominately dacarbazine-base d regimens. Patients included those with American Joint Committee on Cancer Stage IV melanoma, predominately those with lung metastases, but patients with extrapulmonary metastases also were allowed on the study. RESULTS. Five of the 27 patients experienced a complete pulmonary remission . Eight patients achieved a partial pulmonary remission, and 5 patients exp erienced stabilization of their disease. Eight patients developed pulmonary metastases. One patient was not evaluable. Four of the five patients who a chieved a complete response and seven of the eight patients who achieved a partial response previously were treated with dacarbazine and progressed. T here were no responses in extrapulmonary metastases. Side effects of treatm ent were minimal. The complete responses all were durable with a follow-up of 12 months, whereas patients with partial responses and stable disease pr ogressed when IL-2 was discontinued. CONCLUSIONS, Inhalation therapy with IL-2 for pulmonary metastases from mel anoma appears to be safe. The current preliminary study suggests efficacy a lthough concurrent chemotherapy was given, thus confounding results to some extent. Therefore, these results need to be reproduced without concomitant chemotherapy. In addition, a strategy comprised of therapy with IL-2 inhal ation until disease progression may prolong responses. (C) 2000 American Ca ncer Society.