70401 Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
2129 Department of Oncology, Division of Surgical Oncology, University of Calgary, Calgary, AB, Canada.
J Cutan Med Surg. 2021 Jul-Aug;25(4):364-370. doi: 10.1177/1203475420988862. Epub 2021 Feb 2.
Intralesional injection of interleukin-2 (IL-2) for in-transit melanoma (ITM) is associated with a high rate of complete response. However, there is a paucity of data on treatment durability and long-term outcomes.
To provide long-term data on patients with a complete response to IL-2 therapy for ITM.
Consecutive patients with ITM, treated with intralesional IL-2 therapy, at the Tom Baker Cancer Center were identified from April 2009 to August 2019. All patients received at least 4 cycles (every 2 weeks) of IL-2 (5 MIU/mL). Complete response was defined as sustained (ie, 3 months) clinical complete remission of all known in-transit disease.
Sixty-five patients were treated with curative intent for in-transit disease with intralesional IL-2. Complete clinical response was identified in 44.6% (29/65). In this subset of patients, the median number of lesions per patient was 9 (range 1-40). The median total dose of IL-2 was 0.8 mL (IQR 0.4-1.5) per lesion. One patient received isolated limb infusion and 13.8% (4/29) received systemic immunotherapy as part of their initial management. At a median follow-up of 27 months (IQR 16-59), 34.5% (10/29) developed recurrent disease. Of these patients, 50.0% (5/10) presented with synchronous in-transit and distant metastases. The median time to recurrence was 10.5 months (IQR 5.8-16.3).
With long-term follow-up, 65.5% of complete responders have a durable response to intralesional IL-2 therapy. In this cohort of patients, local in-transit recurrence is most likely to occur within 12 months and is often associated with concomitant distant disease.
白细胞介素-2（IL-2）的病灶内注射用于治疗转移黑色素瘤（ITM）可实现高完全缓解率。然而，关于治疗持久性和长期结果的数据很少。
提供接受 ITM 病灶内 IL-2 治疗后完全缓解患者的长期数据。
从 2009 年 4 月至 2019 年 8 月，在汤姆贝克癌症中心，连续识别出接受病灶内 IL-2 治疗的 ITM 患者。所有患者均接受至少 4 个周期（每 2 周一次）的 IL-2（5MIU/mL）。完全缓解定义为所有已知转移疾病的持续（即 3 个月）临床完全缓解。
65 例患者因 ITM 接受病灶内 IL-2 治疗以达到治愈目的。44.6%（29/65）的患者确定有完全临床缓解。在这组患者中，每位患者的病变中位数为 9（范围 1-40）。每个病变的 IL-2 总剂量中位数为 0.8 毫升（IQR 0.4-1.5）。1 例患者接受孤立肢体输注，13.8%（4/29）患者接受全身免疫治疗作为初始治疗的一部分。在中位随访 27 个月（IQR 16-59）时，34.5%（10/29）的患者出现复发性疾病。在这些患者中，50.0%（5/10）出现同步转移和远处转移。复发的中位时间为 10.5 个月（IQR 5.8-16.3）。
通过长期随访，65.5%的完全缓解者对病灶内 IL-2 治疗有持久的反应。在该患者队列中，局部 ITM 复发最有可能在 12 个月内发生，并且通常与同时发生的远处疾病相关。
