Early depressive symptoms in cancer patients receiving interleukin 2 and/or interferon alfa-2b therapy

Purpose: Depressive symptomatology is frequently associated with interleuki n (IL)-2 and interferon alfa-2b (INF alpha-2b) therapy in cancer patients. The objective of the present study was to evaluate the depressive and anxie ty symptoms induced by IL-2 and/or INF alpha-2b in cancer patients during t he first days of cytokine immunotherapy. Patients and Methods: The study included 48 patients with renal cell carcin oma or melanoma, Patients were treated either with subcutaneous IL-2, alone (n = 20) or in combination with INF alpha-2b (n = 6); or with INF alpha-2b alone, administered subcutaneously at a low dose (n = 8) or inf ravenously at a high dose (n = 14). Depressive symptoms were evaluated using the Mont gomery and Asberg Depression Rating Scale (MADRS), and anxiety symptoms wer e evaluated using the Covi scale. Evaluations were performed just before in itiation of treatment (day 1) and on days 3 and 5 of treatment. Results: Patients treated with IL-2 alone or in association with INF alpha- 2b had significantly higher MADRS scores after 5 days of cytokine therapy, and patients who received both cytokines had increased scores on day 3. In contrast patients treated with INF alpha-2b alone did not have varying MADR S scores during the course of treatment. Cytokine therapy had no effect on anxiety, except in patients treated with IL-2 in combination with INF alpha -2b. In these patients, the enhancement in anxiety scores that was observed on day 5 was mainly attributable to increased somatic complaints. Conclusion: IL-2 and INF alpha-2b have differential effects on mood, and IL -2 therapy induces depressive symptoms early in treatment. J Clin Oncol 18: 2143-2157. (C) 2000 by American Society of Clinical Oncology.