Clark Joseph I, Curti Brendan, Davis Elizabeth J, Kaufman Howard, Amin Asim, Alva Ajjai, Logan Theodore F, Hauke Ralph, Miletello Gerald P, Vaishampayan Ulka, Johnson Douglas B, White Richard L, Wiernik Peter H, Dutcher Janice P
Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA.
Earle A. Chiles Research Institute, Providence Medical Center, Portland, Oregon, USA.
J Investig Med. 2021 Feb 4;69(4):888-92. doi: 10.1136/jim-2020-001650.
High-dose interleukin-2 (HD IL-2) was approved in the 1990s after demonstrating durable complete responses (CRs) in some patients with metastatic melanoma (mM) and metastatic renal cell carcinoma (mRCC). Patients who achieve this level of disease control have also demonstrated improved survival compared with patients who progress, but limited data are available describing the long-term course. The aim of this study was to better characterize long-term survival following successful HD IL-2 treatment in patients with no subsequent systemic therapy. Eleven HD IL-2 treatment centers identified patients with survival ≥5 years after HD IL-2, with no subsequent systemic therapy. Survival was evaluated from the date of IL-2 treatment to June 2017. Treatment courses consisted of 2 1-week cycles of HD IL-2. Patients were treated with HD IL-2 alone, or HD IL-2 followed by local therapy to achieve maximal response. 100 patients are reported: 54 patients with mM and 46 patients with mRCC. Progression-free survival (PFS) after HD IL-2 ranges from 5+ years to 30+ years, with a median follow-up of 10+ years. 27 mRCC and 32 mM are alive ≥10 years after IL-2. Thus, a small subset of patients with mM and mRCC achieve long-term PFS (≥5 years) after treatment with HD IL-2 as their only systemic therapy. The ability of HD IL-2 therapy to induce prolonged PFS should be a major consideration in studies of new immunotherapy combinations for mM and mRCC.
大剂量白细胞介素-2(HD IL-2)在20世纪90年代获批,此前已证明其在部分转移性黑色素瘤(mM)和转移性肾细胞癌(mRCC)患者中可产生持久的完全缓解(CR)。与疾病进展的患者相比,达到这种疾病控制水平的患者生存期也有所改善,但描述其长期病程的数据有限。本研究的目的是更好地描述在未接受后续全身治疗的患者中,HD IL-2治疗成功后的长期生存情况。11个HD IL-2治疗中心确定了HD IL-2治疗后生存≥5年且未接受后续全身治疗的患者。从IL-2治疗日期至2017年6月评估生存期。治疗疗程包括2个为期1周的HD IL-2周期。患者单独接受HD IL-2治疗,或在HD IL-2治疗后接受局部治疗以达到最大反应。共报告了100例患者:54例mM患者和46例mRCC患者。HD IL-2后的无进展生存期(PFS)为5年以上至30年以上,中位随访时间为10年以上。27例mRCC和32例mM在IL-2治疗后存活≥10年。因此,一小部分mM和mRCC患者在仅接受HD IL-2作为全身治疗后可实现长期PFS(≥5年)。在针对mM和mRCC的新免疫治疗联合方案研究中,HD IL-2疗法诱导长期PFS的能力应作为主要考虑因素。