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肾细胞癌:重组白细胞介素-2联合β-干扰素治疗

Renal cell carcinoma: treatment with recombinant interleukin-2 plus beta-interferon.

作者信息

Krigel R L, Padavic-Shaller K A, Rudolph A R, Konrad M, Bradley E C, Comis R L

机构信息

Fox Chase Cancer Center, Philadelphia, PA 19111.

出版信息

J Clin Oncol. 1990 Mar;8(3):460-7. doi: 10.1200/JCO.1990.8.3.460.

Abstract

Preclinical data have demonstrated synergy between interleukin-2 (IL-2) and beta-interferon (IFN-beta) in stimulating natural-killer (NK) cell activity and in increasing expression of IL-2 receptors. Based on results of a phase I trial, a combination of IL-2 and IFN-beta was administered three times weekly by intravenous (IV) bolus injection with 5 x 10(6) Cetus U/m2 of IL-2 and 6 x 10(6) U/m2 of IFN-beta to 24 patients with advanced renal cell carcinoma (RCC). Of 22 assessable patients there were six (27%) objective responses including one complete remission (CR) and five partial responses (PRs). There were three minor responses (MRs), 11 stable disease (SD), and two progressive disease (PD). Two of the objective responses have continued for almost 2 years. Response sites include lymph nodes, lungs, and bone. Toxicities requiring dose reduction include arthralgia, weight loss, fatigue, decreased performance status, depression, and hypotension. Five of 10 patients who had a prior nephrectomy without local recurrence achieved an objective response as compared with only one of 12 without a prior nephrectomy or with a local recurrence (P = .04). Mean peak lymphokine-activated killer (LAK) cell activity of the objective responders was 88 lytic units (LU) as compared with 4 LU in the nonresponders (P = .01). Mean peak NK cell activity was 288 LU in the objective responders as compared with 100 LU in the nonresponders (P = .10).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

临床前数据已证明白细胞介素-2(IL-2)和β干扰素(IFN-β)在刺激自然杀伤(NK)细胞活性以及增加IL-2受体表达方面具有协同作用。基于一项I期试验的结果,对24例晚期肾细胞癌(RCC)患者,以每周3次的频率静脉推注给予IL-2和IFN-β的联合用药,剂量分别为5×10⁶ 赛特斯单位/平方米的IL-2和6×10⁶单位/平方米的IFN-β。在22例可评估患者中,有6例(27%)出现客观缓解,包括1例完全缓解(CR)和5例部分缓解(PR)。有3例轻微缓解(MR)、11例疾病稳定(SD)和2例疾病进展(PD)。其中2例客观缓解持续了近2年。缓解部位包括淋巴结、肺和骨。需要降低剂量的毒性反应包括关节痛、体重减轻、疲劳、体能状态下降、抑郁和低血压。10例既往行肾切除术且无局部复发的患者中有5例获得客观缓解,而12例未行肾切除术或有局部复发的患者中只有1例获得客观缓解(P = 0.04)。客观缓解者的平均峰值淋巴因子激活的杀伤(LAK)细胞活性为88溶细胞单位(LU),而无缓解者为4 LU(P = 0.01)。客观缓解者的平均峰值NK细胞活性为288 LU,无缓解者为100 LU(P = 0.10)。(摘要截断于250字)

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