Feldman Darren R, Kondagunta G Varuni, Schwartz Lawrence, Patil Sujata, Ishill Nicole, DeLuca John, Russo Paul, Motzer Robert J
Genitourinary Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Clin Genitourin Cancer. 2008 Mar;6(1):25-30. doi: 10.3816/cgc.2008.n.004.
Pegylated interferon (IFN) has a longer serum half-life compared with standard IFN, and this allows for weekly dosing. In this study, the efficacy and toxicity of pegylated IFN was assessed in patients with metastatic renal cell carcinoma (mRCC).
Thirty-two patients with previously untreated mRCC were treated with pegylated IFN-alpha 2b in a prospective, single-arm phase II trial. Pegylated IFN was given by subcutaneous administration on a weekly schedule at a dose of 4.5 microg/kg.
Of the 32 assessable patients, 29 (91%) had a nephrectomy previously, and none had been treated previously with systemic therapy. Forty-one percent had good-risk, 53% had intermediate-risk, and 6% had poor-risk features per Memorial Sloan-Kettering Cancer Center risk criteria. The best response was a complete response (CR) in 1 patient (3%). Nine patients (28%) had a partial response. Fifteen patients (47%) had stable disease. The median progression-free survival (PFS) was 5 months (95% CI, 3-7 months), and median overall survival was 31 months (95% CI, 18 months to not reached). Five patients had a prolonged PFS of > or = 17 months, 1 of whom achieved a CR. There were no grade 4 toxicities; primary grade 3 toxicities were hematologic (11 of 32 patients; 34%) and fatigue (4 of 32 patients; 13%).
Pegylated IFN administered weekly has antitumor activity in patients with mRCC with predominantly good- and intermediate-risk features. This study suggests comparable efficacy and safety compared with standard IFN-alpha.
与标准干扰素相比,聚乙二醇化干扰素(IFN)的血清半衰期更长,这使得可以每周给药一次。在本研究中,对转移性肾细胞癌(mRCC)患者评估了聚乙二醇化干扰素的疗效和毒性。
在一项前瞻性单臂II期试验中,32例先前未接受治疗的mRCC患者接受聚乙二醇化干扰素α-2b治疗。聚乙二醇化干扰素通过皮下注射给药,每周一次,剂量为4.5μg/kg。
在32例可评估患者中,29例(91%)先前接受过肾切除术,且均未接受过全身治疗。根据纪念斯隆凯特琳癌症中心风险标准,41%具有低风险特征,53%具有中风险特征,6%具有高风险特征。最佳反应为1例患者(3%)完全缓解(CR)。9例患者(28%)部分缓解。15例患者(47%)疾病稳定。中位无进展生存期(PFS)为5个月(95%CI,3 - 7个月),中位总生存期为31个月(95%CI,18个月至未达到)。5例患者的PFS延长至≥17个月,其中1例实现CR。无4级毒性反应;主要3级毒性反应为血液学毒性(32例患者中的11例;34%)和疲劳(32例患者中的4例;13%)。
每周给药的聚乙二醇化干扰素对主要具有低风险和中风险特征的mRCC患者具有抗肿瘤活性。本研究表明,其疗效和安全性与标准干扰素α相当。