Geertsen P F, Gore M E, Negrier S, Tourani J M, von der Maase H
Department of Oncology, University of Copenhagen in Herlev Hospital, Amtssygehuset i Herlev, Denmark.
Br J Cancer. 2004 Mar 22;90(6):1156-62. doi: 10.1038/sj.bjc.6601709.
A retrospective analysis was conducted on data from four open-label, nonrandomised, phase II trials of recombinant interleukin-2 (rIL-2) in patients with metastatic renal cell carcinoma to compare the safety and efficacy of administration by subcutaneous (s.c.) and continuous intravenous (c.i.v.) infusion (n=103 s.c. and n=225 c.i.v.). No statistically significant differences were found between the cohorts in terms of overall response rate (s.c.: 13.6% vs c.i.v.: 12.4%, P=0.77), response duration (s.c.: 9.8 months vs c.i.v.: 10.1 months, P=0.99), and overall survival (P=0.08). Compared with c.i.v. administration, more patients in the s.c. cohort experienced stable disease (50.5 vs 29.8%) and fewer underwent disease progression (35.0 vs 43.6%). Subcutaneous administration was associated with a significantly lower incidence of grade 3 or 4 adverse events (46 vs 76%; P<0.001), and fewer s.c. patients required dose reductions because of toxicity (20 vs 82%). At the doses and within the schedules tested, this comparative analysis did not detect any difference in efficacy between s.c. and c.i.v. administration of rIL-2 in terms of overall survival, duration of response and response rate in patients with metastatic renal cell carcinoma. However, s.c. delivery of rIL-2 was associated with improved tolerability.
对四项关于重组白细胞介素-2(rIL-2)治疗转移性肾细胞癌患者的开放标签、非随机II期试验数据进行回顾性分析,以比较皮下(s.c.)给药和持续静脉(c.i.v.)输注给药的安全性和疗效(皮下给药组n = 103,静脉输注组n = 225)。在总体缓解率(皮下给药组:13.6% vs静脉输注组:12.4%,P = 0.77)、缓解持续时间(皮下给药组:9.8个月vs静脉输注组:10.1个月,P = 0.99)和总生存期(P = 0.08)方面,两组之间未发现统计学上的显著差异。与静脉输注给药相比,皮下给药组更多患者病情稳定(50.5% vs 29.8%),疾病进展的患者更少(35.0% vs 43.6%)。皮下给药与3级或4级不良事件的发生率显著较低相关(46% vs 76%;P<0.001),且因毒性需要降低剂量的皮下给药患者更少(20% vs 82%)。在测试的剂量和给药方案范围内,这项比较分析未发现皮下给药和静脉输注给药的rIL-2在转移性肾细胞癌患者的总生存期、缓解持续时间和缓解率方面的疗效有任何差异。然而,皮下注射rIL-2的耐受性更好。