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皮下注射白细胞介素-2和α-干扰素2b治疗转移性肾细胞癌患者:德国门诊治疗经验

Subcutaneous interleukin-2 and interferon-alpha 2b in patients with metastatic renal cell cancer: the German outpatient experience.

作者信息

Kirchner H, Körfer A, Palmer P A, Evers P, De Riese W, Knüver-Hopf J, Hadam M, Goldman U, Franks C R, Poliwoda H

机构信息

Department of Hematology and Oncology, MHH University Medical Center, Hannover, Germany.

出版信息

Mol Biother. 1990 Sep;2(3):145-54.

PMID:2222898
Abstract

A phase II clinical trial was conducted using subcutaneous recombinant human interleukin-2 (rIL-2, EuroCetus) and subcutaneous interferon-alpha 2b (rIFN-alpha 2b, Essex) in patients with advanced cancer. Safety and tolerance of this outpatient regimen were assessed in 17 patients with progressive metastatic renal carcinoma, 14 of whom were evaluable for clinical response to combined rIL-2 and rIFN-alpha 2b. In this study, rIL-2 was administered every 12 hours, at 1.5 million (Cetus) U/m2 on days 1 and 2, followed by 0.3 million U/m2 5 days per week for 6 consecutive weeks. Concomitantly, rIFN-alpha 2b was given as 5 million U/m2 three times weekly for 6 consecutive weeks. Patients presenting with stable or regressive disease after 6 weeks of rIL-2 and rIFN-alpha 2b (11 of 14) were scheduled to repeat combination therapy. After one treatment cycle, five of 14 patients presented with partial remission; two of these patients achieved complete regression of metastatic lesions. After therapy, six patients have been in stable disease for up to 8 months. toxicity of this regimen was moderate, with local inflammation of the injection sites, grade I-II (World Health Organization criteria) fevers, chills, malaise, nausea and/or vomiting, and anorexia in 70% to 100% of patients treated. After 6 weeks of rIL-2 and rIFN-alpha 2b, laboratory evidence of treatment-related hypothyroidism and hyperthyroidism was obtained in one and four patients, respectively. Immunogenicity of sc rIL-2 was mostly limited to the development of nonneutralizing antibodies that occurred in approximately 40% of patients. None of the patients exhibited antibodies specific to rIFN-alpha 2b.

摘要

一项II期临床试验在晚期癌症患者中使用皮下注射重组人白细胞介素-2(rIL-2,欧洲赛特斯公司)和皮下注射干扰素-α 2b(rIFN-α 2b,埃塞克斯公司)进行。对17例进展期转移性肾癌患者评估了这种门诊治疗方案的安全性和耐受性,其中14例可评估联合使用rIL-2和rIFN-α 2b后的临床反应。在本研究中,rIL-2每12小时给药一次,第1天和第2天的剂量为150万(赛特斯公司)U/m²,随后连续6周每周5天,剂量为30万U/m²。同时,rIFN-α 2b每周三次,每次500万U/m²,连续6周。接受rIL-2和rIFN-α 2b治疗6周后病情稳定或缓解的患者(14例中的11例)计划重复联合治疗。经过一个治疗周期后,14例患者中有5例出现部分缓解;其中2例患者的转移病灶完全消退。治疗后,6例患者病情稳定长达8个月。该治疗方案的毒性为中度,70%至100%接受治疗的患者出现注射部位局部炎症、I-II级(世界卫生组织标准)发热、寒战、不适、恶心和/或呕吐以及厌食。接受rIL-2和rIFN-α 2b治疗6周后,分别有1例和4例患者出现与治疗相关的甲状腺功能减退和甲状腺功能亢进的实验室证据。皮下注射rIL-2的免疫原性主要局限于非中和抗体的产生,约40%的患者出现此类抗体。没有患者表现出针对rIFN-α 2b的特异性抗体。

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