Byers Brett A, Temple-Oberle Claire F, Hurdle Valerie, McKinnon J Greg
Division of Plastic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.
J Surg Oncol. 2014 Nov;110(6):770-5. doi: 10.1002/jso.23702. Epub 2014 Jul 3.
Several phase II studies have assessed intra-lesional interleukin-2 (IL-2) for the treatment of in-transit melanoma. This systematic review addresses the efficacy and side effect profile of IL-2.
MEDLINE, EMBASE, Cochrane Library, and Google Scholar databases were searched from 1980 to 2012 for studies evaluating the clinical response to IL-2 for in-transit melanoma. Titles and abstracts were screened by two independent researchers for suitability using predetermined inclusion and exclusion criteria. A modified quality assessment tool for observational studies was used. Data were pooled and analyzed to determine lesion and patient response rates.
Forty-nine studies were identified. Forty-three did not meet inclusion criteria, leaving six observational trials. Heterogeneity was seen in IL-2 dosage and treatment interval. Response rate was variable as well. Overall, 2,182 lesions and 140 patients were treated in these six studies. Pooling the lesions, complete response was seen in 78%. Pooling subjects, 50% achieved a complete response. Treatment was generally well tolerated, with localized pain and swelling, and mild flu-like symptoms. There were only three grade 3 adverse events reported, including rigors, headache, and fever with arthralgia.
Intra-lesional IL-2 safely and effectively provides locoregional control of in-transit melanoma.
多项II期研究评估了病灶内注射白细胞介素-2（IL-2）治疗移行性黑素瘤的效果。本系统评价探讨了IL-2的疗效和副作用情况。
检索1980年至2012年期间的MEDLINE、EMBASE、Cochrane图书馆和谷歌学术数据库，查找评估IL-2治疗移行性黑素瘤临床反应的研究。由两名独立研究人员根据预先确定的纳入和排除标准筛选标题和摘要，以确定其是否合适。使用一种改良的观察性研究质量评估工具。汇总并分析数据，以确定病灶和患者的反应率。
共识别出49项研究。43项不符合纳入标准，最终纳入6项观察性试验。IL-2剂量和治疗间隔存在异质性。反应率也各不相同。总体而言，这6项研究共治疗了2182个病灶和140名患者。汇总病灶数据，完全缓解率为78%。汇总受试者数据，完全缓解率为50%。治疗一般耐受性良好，有局部疼痛和肿胀，以及轻度流感样症状。仅报告了3例3级不良事件，包括寒战、头痛和发热伴关节痛。
病灶内注射IL-2可安全有效地实现移行性黑素瘤的局部区域控制。
