K A Foon, P J Walther, Z P Bernstein, L Vaickus, R Rahman, H Watanabe, J Sweeney, J Park, D Vesper, D Russell
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引用次数: 21
摘要
高剂量重组白细胞介素-2 (il -2)在转移性肾细胞癌患者中的肿瘤应答率为9%至31%。持续输注il -2的方案可能毒性较小,并可能导致体内淋巴因子激活的杀伤细胞(LAK)的产生。目前的试验使用体外LAK细胞连续输注rIL-2。这些细胞用苯丙氨酸甲酯预处理,去除单核细胞,以便在更高浓度下进行细胞培养。23名患者参加了试验。2例患者完全缓解(9%)持续15+和20+个月。4例患者的部分缓解(17%)分别为9+、6+、3 +和3个月。一个部分应答者在9个月以上时只有少量残留的腹膜后疾病,可能代表疤痕组织。所有应答者之前都有过肾切除术。除一名应答患者外,所有患者均以最高(起始)剂量(6 × 10(6) U/m2)完成了一个完整周期的rIL-2治疗。这种rIL-2/LAK方案似乎是转移性肾细胞癌的有效治疗方法。
Renal cell carcinoma treated with continuous-infusion interleukin-2 with ex vivo-activated killer cells.
High-dose recombinant interleukin-2 (rIL-2) results in tumor responses in patients with metastatic renal cell carcinoma ranging from 9 to 31%. Continuous infusion regimens of rIL-2 may be less toxic and may result in greater in vivo lymphokine-activated killer (LAK) cell production. The current trial used a continuous infusion of rIL-2 with ex vivo LAK cells. These cells were pretreated with phenylalanine methyl ester to remove monocytes to allow cell culture at higher concentrations. Twenty-three patients were entered into the trial. Two patients had complete responses (9%) lasting 15+ and 20+ months. Four patients had partial responses (17%) of 9+, 6+, 3, and 3 months, respectively. One partial responder at 9+ months had only minimal residual retroperitoneal disease that may represent scar tissue. All responders had prior nephrectomies. All but one of the responding patients completed a full cycle of rIL-2 at the highest (starting) dose, 6 x 10(6) U/m2. This rIL-2/LAK regimen appears to be an effective therapy for metastatic renal cell carcinoma.