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重组人白细胞介素-2与重组干扰素α-2A联合用于癌症患者的治疗:一项I期研究。

Concomitant administration of recombinant human interleukin-2 and recombinant interferon alpha-2A in cancer patients: a phase I study.

作者信息

Lee K H, Talpaz M, Rothberg J M, Murray J L, Papadopoulos N, Plager C, Benjamin R, Levitt D, Gutterman J

机构信息

Department of Clinical Immunology and Biological Therapy, University of Texas M.D. Anderson Cancer Center, Houston 77030.

出版信息

J Clin Oncol. 1989 Nov;7(11):1726-32. doi: 10.1200/JCO.1989.7.11.1726.

Abstract

Twenty-seven patients with metastatic cancer were treated with a daily continuous intravenous (IV) infusion of recombinant human interleukin-2 (rhIL-2) along with daily intramuscular recombinant interferon-alpha-2a (rIFN-alpha-2a) 4 days per week for 4 weeks with repeated treatment after 2 to 4 weeks of rest. The maximum-tolerated dose (MTD) was 3 million U/m2/d of rhIL-2 with 5 to 10 million U/m2/d of rIFN-alpha-2a. The dose-limiting toxicities are moderate hypotension requiring low doses of pressors and chronic fatigue associated with decreased performance status. Other common side effects included fever, chills, fluid retention, nausea/vomiting, erythrodermia, weight loss, elevated liver transminase levels, anemia, thrombocytopenia, and CNS toxic effects. There were seven objective responses among 25 evaluable patients. Four major responses (one complete response and three partial responses) were observed among 10 patients with melanoma treated with the MTD level. These data suggest that for cancer patients, concomitant rhIL-2 and rIFN-alpha-2a therapy is tolerable and has manageable side effects. Further phase II studies will be needed to define the antitumor activity of this combination.

摘要

27例转移性癌症患者接受治疗,每天持续静脉输注重组人白细胞介素-2(rhIL-2),同时每周4天每天肌肉注射重组干扰素-α-2a(rIFN-α-2a),共4周,休息2至4周后重复治疗。rhIL-2的最大耐受剂量(MTD)为300万U/m²/d,rIFN-α-2a为500至1000万U/m²/d。剂量限制性毒性为需要低剂量升压药的中度低血压和与体能状态下降相关的慢性疲劳。其他常见副作用包括发热、寒战、液体潴留、恶心/呕吐、红皮病、体重减轻、肝转氨酶水平升高、贫血、血小板减少和中枢神经系统毒性作用。25例可评估患者中有7例出现客观缓解。在接受MTD水平治疗的10例黑色素瘤患者中观察到4例主要缓解(1例完全缓解和3例部分缓解)。这些数据表明,对于癌症患者,rhIL-2和rIFN-α-2a联合治疗是可耐受的,且副作用可控。需要进一步的II期研究来确定这种联合治疗的抗肿瘤活性。

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