High-dose interleukin 2 in patients with metastatic renal cell carcinoma with sarcomatoid features
| Autor: | Ananth Arjunan, Melissa Saul, Rahul Atul Parikh, Hong Wang, Tala Achkar, Diwakar Davar, Leonard Joseph Appleman, David M. Friedland |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_treatment Cancer Treatment 030232 urology & nephrology lcsh:Medicine Kaplan-Meier Estimate Drug research and development Nephrectomy Gastroenterology Metastasis Clinical trials 0302 clinical medicine Renal cell carcinoma Basic Cancer Research Medicine and Health Sciences lcsh:Science Lymph node Clinical Trials as Topic Multidisciplinary Sarcoma Cell Differentiation Middle Aged Prognosis Kidney Neoplasms Exact test medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Cohort Female Anatomy Phase II clinical investigation Research Article medicine.medical_specialty Histology Surgical and Invasive Medical Procedures Carcinomas Urinary System Procedures 03 medical and health sciences Diagnostic Medicine Internal medicine medicine Carcinoma Humans Carcinoma Renal Cell Pharmacology Dose-Response Relationship Drug Surgical Excision business.industry lcsh:R Renal Cell Carcinoma Cancers and Neoplasms Biology and Life Sciences medicine.disease Research and analysis methods Genitourinary Tract Tumors Clinical medicine Localized disease Interleukin-2 lcsh:Q business Developmental Biology |
| Zdroj: | PLoS ONE, Vol 12, Iss 12, p e0190084 (2017) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background High-dose interleukin-2 (HD IL-2) is used in the treatment of metastatic renal cell carcinoma (mRCC) and has an overall response rate (ORR) of 12–20% and a complete response rate (CR) of 8% in unselected populations with predominantly clear cell type renal cell carcinoma. Nearly 10–15% of patients with renal cell carcinoma exhibit sarcomatoid differentiation, a feature which correlates with a median overall survival (OS) of 9 months and overall poor prognosis. We report a single institution experience with 21 patients with mRCC with sarcomatoid features post-nephrectomy who were treated with HD IL-2. Methods Twenty one patients with mRCC with sarcomatoid features post-nephrectomy who underwent therapy with HD IL-2 were identified at the University of Pittsburgh Medical Center from 2004 to 2016. Baseline patient characteristics, HD IL-2 cycles, time to progression, and subsequent therapies were evaluated. OS and progression-free survival (PFS) in the cohort were calculated using the Kaplan-Meier method. Disease characteristics were evaluated for significance using the Fischer′s exact test and Wilcoxon rank sum test. Results Patients were predominantly Caucasian males with a median age of 54 years. A majority, 86% of these patients, had metastatic disease at time of initial presentation, primarily with lung and lymph node involvement. The ORR and CR with HD IL-2 was 10% and 5%, respectively. Initial localized disease presentation is the only variable that was significantly associated with response to HD IL-2 (p = 0.0158). Number of HD IL-2 doses did not correlate with response with a mean of 16.5 and 15.0 total doses in responders and non-responders, respectively (p = 0.53). Median PFS with HD IL-2 was 7.9 months (95% CI, 5.0–21.3). Median OS was 30.5 months (95% CI 13.3–57.66). Within the subset of patients who had progression on IL-2, median OS was 19.4 months (95% CI, 13.3–35.3). In patients who received second-line therapy, median PFS was 7.9 months (95% CI 2.4–10.2). Conclusion In patients with mRCC with sarcomatoid features, use of HD IL-2 was associated with a modest ORR and a higher survival compared to historical controls (patients with mRCC and sarcomatoid features). Thus, HD IL-2 may have a role in treating selected patients with mRCC with sarcomatoid features. |
| Databáze: | OpenAIRE |
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