Younes Anas, Pro Barbara, Robertson Michael J, Flinn Ian W, Romaguera Jorge E, Hagemeister Fredrick, Dang Nam H, Fiumara Paolo, Loyer Evelyne M, Cabanillas Fernando F, McLaughlin Peter W, Rodriguez Maria Alma, Samaniego Felipe
Department of Lymphoma and Myeloma, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Clin Cancer Res. 2004 Aug 15;10(16):5432-8. doi: 10.1158/1078-0432.CCR-04-0540.
The purpose of this study was to evaluate the clinical activity and toxicity of recombinant human Interleukin (IL)-12 in patients with relapsed and refractory non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD).
Forty-two previously treated patients (32 patients with NHL and 10 patients with HD) were enrolled on the study. Patients were treated with either intravenous (n = 11) or subcutaneous (n = 31) administration of IL-12. The patients had received a median of three prior treatment regimens, and 16 patients had undergone prior autologous stem cell transplantation.
All patients were assessable for toxicity, and 39 of 42 (93%) patients were assessable for response. Six of 29 (21%) patients with NHL had a partial or complete response, whereas none of the 10 patients with HD responded. Furthermore, 15 patients had stable disease that lasted for up to 54 months. Progression-free survival in patients with indolent NHL, aggressive NHL, and HD was 6, 2, and 2.5 months, respectively. Treatment was well tolerated, and the most common toxicity was flu-like symptoms. Reversible grade 3 hepatic toxicity was observed in three patients requiring dose reduction. IL-12 therapy increased the median number of peripheral blood CD8 T lymphocytes from 423/microl to 576/microl (P = 0.0019). Furthermore, IL-12 therapy decreased serum vascular endothelial growth factor and basic fibroblast growth factor concentrations in 37% of the patients.
The ability of recombinant human IL-12 therapy to increase the number of circulating CD8+ cells and induce clinical remissions in patients with relapsed NHL warrants further investigation of the drug.
本研究旨在评估重组人白细胞介素(IL)-12对复发难治性非霍奇金淋巴瘤(NHL)或霍奇金病(HD)患者的临床活性和毒性。
42例先前接受过治疗的患者(32例NHL患者和10例HD患者)入组本研究。患者接受静脉注射(n = 11)或皮下注射(n = 31)IL-12治疗。患者接受过的先前治疗方案中位数为3种,16例患者曾接受过自体干细胞移植。
所有患者均可评估毒性,42例患者中有39例(93%)可评估疗效。29例NHL患者中有6例(21%)有部分或完全缓解,而10例HD患者均无反应。此外,15例患者病情稳定,持续时间长达54个月。惰性NHL、侵袭性NHL和HD患者的无进展生存期分别为6、2和2.5个月。治疗耐受性良好,最常见的毒性是流感样症状。3例患者出现可逆性3级肝毒性,需要降低剂量。IL-12治疗使外周血CD8 T淋巴细胞中位数从423/μl增加到576/μl(P = 0.0019)。此外,IL-12治疗使37%的患者血清血管内皮生长因子和碱性成纤维细胞生长因子浓度降低。
重组人IL-12治疗增加复发NHL患者循环CD8+细胞数量并诱导临床缓解的能力值得对该药物进行进一步研究。