Medical Oncology Department, Hoag Institute for Research and Education and Hoag Family Cancer Institute, Newport Beach, CA 92658, USA.
Cancer Biother Radiopharm. 2012 Aug;27(6):337-43. doi: 10.1089/cbr.2012.1220.
For more than 20 years interleukin-2 (IL2) was the preferred treatment for medically fit metastatic melanoma patients, but recently two new agents, ipilimumab and vemurafenib, were approved for stage IV disease. Single-institution data were used to determine the long-term survival rate for IL2-treated melanoma patients, and whether use of inpatient IL2 had declined recently. Between May 1987 and April 2010, 150 patients were hospitalized for high-dose, intravenous (i.v.) IL2. The average number of IL2 patients increased from 5.4 per year during 1987-1991 to 5.8 during 1992-1997 after regulatory approval of IL2, to 8.3 during 1998-2006 after a marketing indication in metastatic melanoma was granted, but dropped to 3.0 during 2007-2010. At the time of treatment, median age was 52 years; 27% were 60 years of age or older. At the time of analysis 122 patients were deceased. Median survival from the start date of IL2 treatment was 15.6 months, with a 20% 5-year survival. Among patients enrolled in clinical trials, there were as many nonresponders who survived 5 years as responders, which is consistent with a delayed immunotherapy benefit. In the absence of long-term survival data for these newer agents, IL2 probably should still be the preferred initial treatment for most patients with metastatic melanoma who are medically fit.
20 多年来，白细胞介素-2（IL2）一直是适合医学治疗的转移性黑色素瘤患者的首选治疗方法，但最近两种新药物，易普利姆玛（ipilimumab）和威罗非尼（vemurafenib），已被批准用于 IV 期疾病。单机构数据用于确定接受 IL2 治疗的黑色素瘤患者的长期生存率，以及最近是否减少了住院使用 IL2。1987 年 5 月至 2010 年 4 月期间，有 150 名患者因大剂量静脉（i.v.）IL2 住院治疗。接受 IL2 治疗的患者平均人数从 1987-1991 年的每年 5.4 例增加到监管部门批准 IL2 后 1992-1997 年的每年 5.8 例，在转移性黑色素瘤获得营销适应症后增加到 1998-2006 年的每年 8.3 例，但在 2007-2010 年降至每年 3.0 例。在治疗时，中位年龄为 52 岁；27%的患者年龄在 60 岁或以上。在分析时，有 122 名患者死亡。从 IL2 治疗开始日期算起的中位生存时间为 15.6 个月，20%的患者 5 年生存率。在参加临床试验的患者中，有许多非反应者存活了 5 年，与免疫治疗延迟获益一致。在缺乏这些新药物的长期生存数据的情况下，IL2 可能仍然是大多数适合医学治疗的转移性黑色素瘤患者的首选初始治疗方法。
