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关于使用淋巴因子激活的杀伤细胞和白细胞介素-2或单独使用高剂量白细胞介素-2治疗157例晚期癌症患者的进展报告。

A progress report on the treatment of 157 patients with advanced cancer using lymphokine-activated killer cells and interleukin-2 or high-dose interleukin-2 alone.

作者信息

Rosenberg S A, Lotze M T, Muul L M, Chang A E, Avis F P, Leitman S, Linehan W M, Robertson C N, Lee R E, Rubin J T

出版信息

N Engl J Med. 1987 Apr 9;316(15):889-97. doi: 10.1056/NEJM198704093161501.

DOI:10.1056/NEJM198704093161501
PMID:3493432
Abstract

We studied the effects of adoptive immunotherapy with lymphokine-activated killer (LAK) cells plus interleukin-2 or therapy with high-dose interleukin-2 alone in 157 patients with metastatic cancer for whom standard therapy had proved ineffective or no standard effective treatment was available. One hundred eight patients were treated with 127 courses of LAK cells plus interleukin-2, and 49 patients were treated with 53 courses of high-dose interleukin-2 alone. Of 106 evaluable patients receiving LAK cells plus interleukin-2, 8 had complete responses, 15 had partial responses, and 10 had minor responses. The median duration of response was 10 months among those with complete responses and 6 months among those with partial responses; the patient with the longest complete response was still in remission 22 months after treatment. Of 46 evaluable patients treated with high-dose interleukin-2 alone, 1 had a complete response (remission greater than 4 months), 5 had partial responses (2, greater than 3, greater than 5, 7, and greater than 11 months), and 1 had a minor response. Seven of the total of nine complete responses still remain in remission. Hypotension, weight gain, oliguria, and elevation of bilirubin and creatinine levels were common, but these side effects resolved promptly after interleukin-2 administration was stopped. There have been four treatment-related deaths among these 157 patients. This immunotherapeutic approach can result in marked tumor regression in some patients for whom no other effective therapy is available at present. Determining its ultimate role in cancer therapy awaits further attempts to increase the therapeutic efficacy of treatment and decrease its toxicity and complexity.

摘要

我们对157例转移性癌症患者进行了研究,这些患者的标准治疗已证明无效或没有可用的标准有效治疗方法,研究内容为采用淋巴因子激活的杀伤细胞(LAK)联合白细胞介素-2进行过继性免疫治疗,或单独使用大剂量白细胞介素-2治疗的效果。108例患者接受了127个疗程的LAK细胞联合白细胞介素-2治疗,49例患者单独接受了53个疗程的大剂量白细胞介素-2治疗。在106例可评估的接受LAK细胞联合白细胞介素-2治疗的患者中,8例完全缓解,15例部分缓解,10例轻度缓解。完全缓解者的中位缓解持续时间为10个月,部分缓解者为6个月;缓解持续时间最长的患者在治疗后22个月仍处于缓解状态。在46例单独接受大剂量白细胞介素-2治疗的可评估患者中,1例完全缓解(缓解超过4个月),5例部分缓解(分别为2个月、超过3个月、超过5个月、7个月和超过11个月),1例轻度缓解。9例完全缓解患者中有7例仍处于缓解状态。低血压、体重增加、少尿以及胆红素和肌酐水平升高很常见,但在停止白细胞介素-2给药后这些副作用迅速消失。这157例患者中有4例与治疗相关的死亡。这种免疫治疗方法可使目前没有其他有效治疗方法的一些患者出现明显的肿瘤消退。确定其在癌症治疗中的最终作用有待进一步尝试提高治疗效果并降低其毒性和复杂性。

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