Clinical outcome and prognostic survival factors in patients with advanced renal cell carcinoma treated with very low-dose interleukin-2, interferon-α, and tegafur-uracil: a single-institution experience.

Autor: Kobayashi, Minoru, Ikeda, Hitoshi, Nukui, Akinori, Suzuki, Kazumi, Sugaya, Yasuhiro, Yuzawa, Masayuki, Morita, Tatsuo
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Zdroj: International Journal of Clinical Oncology; Jun2008, Vol. 13 Issue 3, p257-262, 6p, 3 Charts, 4 Graphs
Abstrakt: The objective of the current study was to determine the efficacy and safety of very low-dose interleukin-2 (IL-2), interferon (IFN)-α, and tegafur-uracil for patients with unresectable renal cell carcinoma (RCC), metastatic RCC, or both. Clinical prognostic factors were also investigated. Fifty consecutive patients underwent a 3-week treatment cycle of IL-2 (0.7 × 106 Japanese reference units [JRU])/person on days 1–3 weekly), IFN-α (3 × 106 international units/person, on days 1–5 weekly), and tegafururacil (300 mg/person daily). The median follow-up after treatment initiation was 11.3 months. A median of three (range, 1–20) treatment cycles was administered. Of 47 eligible patients, 4 had a treatment response (3 complete responses and 1 partial response; objective response rate, 8.5%). The median progression-free and overall survivals were 8.3 months (95% confidence interval [CI], 5.5–10.9 months) and 38.8 months (95% CI, 27.8–49.7 months), respectively. Only 8 patients had grade III/IV toxicities. Two parameters, i.e., the absence of a previous nephrectomy and a low hemoglobin level, were identified as independent factors predictive of poor survival. Patients with low or intermediate risk (presence of none or one of the two prognostic factors) had a durable median survival exceeding 30 months. High-risk patients with both risk factors had rapid disease progression despite treatment. While the effectiveness of this immunochemotherapy resulted in a limited antitumor response, low-and intermediate-risk patients with metastatic RCC seemed likely to have a survival benefit. Patient selection is essential to enhance treatment efficiency and avoid useless treatment for high-risk patients. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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