Truitt G A, Brunda M J, Levitt D, Anderson T D, Sherman M I
Department of Oncology, Roche Research Center, Nutley, New Jersey 07110.
Cancer Surv. 1989;8(4):875-89.
Animal studies have been carried out to assess the antitumour efficacy of recombinant interleukin-2 (rIL-2) in combination with other cytokines. In several murine tumour models, rIL-2 in combination with recombinant alpha interferon (rIFN-alpha) elicits a potent antitumour response which is often greater than that which can be reached with the individual agents at non-toxic doses. By contrast, recombinant gamma interferon (rIFN-gamma) usually fails to potentiate the antitumour response to rIL-2. Recombinant alpha tumour necrosis factor (rTNF) can synergize with rIL-2 in some circumstances, but, as with the rIL-2/rIFN-alpha combination, the correct regimen is critical for generating a potent response without overt toxicity. Although appropriate cytokine combinations can lead to markedly enhanced tumour infiltration by lymphocytes, it is not clear that only a single type of lymphocyte is invariably involved in the antitumour response or, for that matter, the toxic side effects; nor has the mechanism of action of any of the cytokines in the therapeutic action been unequivocally elucidated. Finally, results of early clinical studies appear to be consistent with results in preclinical models: promising clinical responses to the combination of rIL-2 and rIFN-alpha have already been observed and further study is merited.
已经开展了动物研究来评估重组白细胞介素-2(rIL-2)与其他细胞因子联合使用时的抗肿瘤疗效。在多个小鼠肿瘤模型中,rIL-2与重组α干扰素(rIFN-α)联合使用可引发强大的抗肿瘤反应,这种反应通常大于在无毒剂量下单独使用这两种药物所能达到的反应。相比之下,重组γ干扰素(rIFN-γ)通常无法增强对rIL-2的抗肿瘤反应。重组α肿瘤坏死因子(rTNF)在某些情况下可与rIL-2协同作用,但与rIL-2/rIFN-α联合使用的情况一样,正确的用药方案对于在不产生明显毒性的情况下产生强大反应至关重要。尽管适当的细胞因子组合可导致淋巴细胞对肿瘤的浸润显著增强,但尚不清楚抗肿瘤反应中是否总是仅涉及单一类型的淋巴细胞,也不清楚毒性副作用的情况;而且任何一种细胞因子在治疗作用中的作用机制也尚未得到明确阐明。最后,早期临床研究结果似乎与临床前模型的结果一致:已经观察到rIL-2和rIFN-α联合使用有令人鼓舞的临床反应,值得进一步研究。