Dutcher Janice P
Oncology (Williston Park). 2002 Nov;16(11 Suppl 13):4-10.
Interleukin-2 (IL-2, Proleukin) is one of the most effective agents in the treatment of metastatic renal cell carcinoma and metastatic melanoma. High-dose IL-2 therapy produces overall response rates of 15% to 20%; however, it is associated with significant toxicities that affect essentially every organ system. Although IL-2-related toxicities are usually reversible with therapy discontinuation, alternative IL-2 regimens have been evaluated. Several phase II studies have demonstrated that administering lower doses of IL-2 by IV bolus or continuous IV infusion or subcutaneously produces overall response rates similar to those with high-dose IL-2 therapy; however, randomized clinical trials have not yet been completed. In renal cell carcinoma, combining IL-2 with interferon alfa (Intron A, Roferon-A) or chemotherapy agents produces similar or increased overall response rates compared with the response rates of IL-2 alone, with no survival advantage. Combination IL-2 regimens in metastatic melanoma patients have produced variable results. The most promising regimens have included various IL-2-based biochemotherapy regimens in other patients. Randomized studies confirming the superiority of these regimens over high-dose IL-2 therapy are needed.
白细胞介素-2（IL-2，普罗力）是治疗转移性肾细胞癌和转移性黑色素瘤最有效的药物之一。高剂量IL-2疗法的总体缓解率为15%至20%；然而，它会引发影响几乎每个器官系统的显著毒性。虽然与IL-2相关的毒性通常在停药后可逆，但已对替代的IL-2治疗方案进行了评估。多项II期研究表明，通过静脉推注、持续静脉输注或皮下注射给予较低剂量的IL-2，总体缓解率与高剂量IL-2疗法相似；然而，随机临床试验尚未完成。在肾细胞癌中，将IL-2与干扰素α（安进公司生产的重组人干扰素α-2b、罗氏公司生产的重组人干扰素α-2a）或化疗药物联合使用，与单独使用IL-2的缓解率相比，总体缓解率相似或有所提高，但无生存优势。转移性黑色素瘤患者的联合IL-2治疗方案产生了不同的结果。最有前景的方案包括其他患者中各种基于IL-2的生物化疗方案。需要进行随机研究来证实这些方案优于高剂量IL-2疗法。
