Royal R E, Steinberg S M, Krouse R S, Heywood G, White D E, Hwu P, Marincola F M, Parkinson D R, Schwartzentruber D J, Topalian S L, Yang J C, Rosenberg S A
Surgery Branch and Biostatistics and Data Management Section, Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-1502, USA.
Cancer J Sci Am. 1996 Mar-Apr;2(2):91-8.
We evaluated the characteristics of patients with metastatic renal cancer or metastatic melanoma prior to and during treatment with bolus intravenous interleukin-2 to define prognostic indicators of subsequent response to therapy.
A consecutive series of 509 patients with progressive metastatic cancer were treated with intravenous interleukin-2 from September 1985 to July 1993. Pretreatment demographic characteristics, treatment history, results of laboratory tests, and metastatic sites of disease were evaluated. The amount of interleukin-2 administered, toxicity, and changes in laboratory test results were recorded for the first course of therapy. Subsequent objective response to therapy and survival were determined and used to evaluate pretreatment and treatment characteristics that acted as prognostic indicators of response.
At the end of the study, 22.6% of patients with renal cancer and 16.3% of patients with melanoma experienced an objective response to interleukin-2 therapy. Patients with renal cancer responded more frequently if they had not previously failed other immunotherapies. Also, renal cancer patients who achieved an objective response had a more profound thrombocytopenia during the first cycle of therapy. Patients with melanoma responded more frequently to interleukin-2 therapy when metastases were confined to subcutaneous tissue. In addition, responding patients with melanoma received more interleukin-2 in their first course and exhibited a more profound lymphocytosis 7 to 11 days after initiating therapy than did nonresponders.
Renal cancer and melanoma displayed separate prognostic indicators with respect to response from interleukin-2 therapy. Although significant correlates to response were identified, there was much variability and a reliable predictive model of response to therapy could not be formulated based on these results.
我们评估了转移性肾癌或转移性黑色素瘤患者在大剂量静脉注射白细胞介素-2治疗前及治疗期间的特征，以确定后续治疗反应的预后指标。
1985年9月至1993年7月，连续对509例进展性转移性癌症患者进行静脉注射白细胞介素-2治疗。评估了患者的预处理人口统计学特征、治疗史、实验室检查结果及疾病的转移部位。记录了首个疗程的白细胞介素-2给药量、毒性及实验室检查结果的变化。确定了后续治疗的客观反应及生存率，并用于评估作为反应预后指标的预处理和治疗特征。
研究结束时，22.6%的肾癌患者和16.3%的黑色素瘤患者对白细胞介素-2治疗有客观反应。未曾在其他免疫治疗中失败的肾癌患者反应更为频繁。此外，获得客观反应的肾癌患者在首个治疗周期中血小板减少更为严重。当转移局限于皮下组织时，黑色素瘤患者对白细胞介素-2治疗的反应更为频繁。此外，有反应的黑色素瘤患者在首个疗程中接受的白细胞介素-2更多，且在开始治疗7至11天后淋巴细胞增多比无反应者更为明显。
肾癌和黑色素瘤在白细胞介素-2治疗反应方面显示出不同的预后指标。尽管确定了与反应的显著相关性，但仍存在很大变异性，基于这些结果无法制定可靠的治疗反应预测模型。
