Int. J. Cancer : 94, 109-120 (2001)
IMMUNOTHERAPY OF METASTATIC KIDNEY CANCER
GIANCARLO PIZZA 1,* CATERINA DE VINCI 1, GIUSEPPE LO CONTE 1, PAOLO MAVER 1, ENNIO DRAGONI 1, ERNESTO AIELLO 1, VITTORIO FORNAROLA 1, TIZIANO BERGAMI 2, LUCIANO BUSUTTI 2, STEFANO BORIANI 3, ALDOPAOLO PALARETI 4 and RODOLFO CAPANNA 5
- Immunotherapy Module, Operative Unit of Urology, Department
of Urology, S. Orsola-Malpighi Hospital, Bologna, Italy
- Operative Unit of Radiotherapy, Department of Oncology, S.
Orsola-Malpighi Hospital, Bologna, Italy
- Operative Unit of Orthopedics, Maggiore Hospital, Bologna,
- Department of Computer Science, University of Bologna, Bologna,
- 2nd Division of Orthopaedics, Reconstructive Surgery Centre,
From April 1986 to September 2000, 122 MRCC patients were treated by monthly intralymphatic injections (containing a mean of 573 IL-2 U and 26 x I06 LAK cells) and i.m. administration of IFN and TF; 71 patients also received a 3-day cycle of monthly IL-2 inhalations with a mean of 998 daily U. MRCC cases not treated by immunotherapy (n = 89) represent our historical controls. Adverse clinical side effects related to treatment were negligible. CR (n = II) and PR (n = 13) were noticed in 24/122 patients. Of 24 responding patients, 17 resumed progression, whereas 7 remain in remission 1-69 months later. The overall median survival of treated patients (28 months) was 3.5-fold higher than the median survival of historical controls (7.5 months), and a Kaplan-Meier curve showed 25% survival 11 years after the beginning of immunotherapy. Apparently, the addition of IL-2 by inhalation improved survival. The present immunotherapy protocol appears to be efficacious, safe, devoid of adverse side effects, far less costly than others, and able to offer a good quality of life to MRCC patients; if confirmed in a multicenter trial, it could set the basis for developing low-dose immunomodulatory treatments.
Abbreviations : CD, cluster designation; CR, complete response; EBRT, external-beam radiotherapy; LAK cells, lymphokine-activated killer cells; MRCC, metastatic renal-cell cancer; MU, mega-unit; PB, peripheral blood; PBL, peripheral blood lymphocyte; PR, partial response; PROG, tumor progression; rIL-2, recombinant IL-2; TF, transfer factor; TNM, tumor, node, metastasis.
See also the commentary by Dr. D. Viza: CERTAINTIES
THAT DEFY REALITY: FROM INTERLEUKIN TO TRANSFER FACTOR
2001, Wiley-Liss, Inc. All rights reserved.