BACKGROUND: The objective of the current study was to determine the efficacy and safety of very low-dose interleukin-2 (IL-2), interferon (IFN)-alpha, and tegafur-uracil for patients with unresectable renal cell carcinoma (RCC), metastatic RCC, or both. Clinical prognostic factors were also investigated. METHODS: Fifty consecutive patients underwent a 3-week treatment cycle of IL-2 (0.7 x 10(6) Japanese reference units [JRU])/person on days 1-3 weekly), IFN-alpha (3 x 10(6) international units/person, on days 1-5 weekly), and tegafururacil (300 mg/person daily). RESULTS: 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. CONCLUSION: 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.
BACKGROUND: The objective of the current study was to determine the efficacy and safety of very low-dose interleukin-2 (IL-2), interferon (IFN)-alpha, and tegafur-uracil for patients with unresectable renal cell carcinoma (RCC), metastatic RCC, or both. Clinical prognostic factors were also investigated. METHODS: Fifty consecutive patients underwent a 3-week treatment cycle of IL-2 (0.7 x 10(6) Japanese reference units [JRU])/person on days 1-3 weekly), IFN-alpha (3 x 10(6) international units/person, on days 1-5 weekly), and tegafururacil (300 mg/person daily). RESULTS: 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. CONCLUSION: 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.
Authors: Robert J Motzer; Thomas E Hutson; Piotr Tomczak; M Dror Michaelson; Ronald M Bukowski; Olivier Rixe; Stéphane Oudard; Sylvie Negrier; Cezary Szczylik; Sindy T Kim; Isan Chen; Paul W Bycott; Charles M Baum; Robert A Figlin Journal: N Engl J Med Date: 2007-01-11 Impact factor: 91.245
Authors: C Buzio; S Andrulli; R Santi; L Pavone; R Passalacqua; D Potenzoni; F Ferrozzi; R Giacosa; A Vaglio Journal: Cancer Date: 2001-11-01 Impact factor: 6.860
Authors: C Buzio; G De Palma; R Passalacqua; D Potenzoni; F Ferrozzi; M A Cattabiani; L Manenti; A Borghetti Journal: Br J Cancer Date: 1997 Impact factor: 7.640
Authors: Bradley C Leibovich; Ken-ryu Han; Matthew H T Bui; Allan J Pantuck; Frederick J Dorey; Robert A Figlin; Arie Belldegrun Journal: Cancer Date: 2003-12-15 Impact factor: 6.860
Authors: Christopher W Ryan; Bryan H Goldman; Primo N Lara; Philip C Mack; Tomasz M Beer; Catherine M Tangen; Dianne Lemmon; Chong-Xian Pan; Harry A Drabkin; E David Crawford Journal: J Clin Oncol Date: 2007-08-01 Impact factor: 44.544
Authors: J Atzpodien; E Lopez Hänninen; H Kirchner; H Bodenstein; M Pfreundschuh; U Rebmann; B Metzner; H J Illiger; G Jakse; T Niesel Journal: J Clin Oncol Date: 1995-02 Impact factor: 44.544
Authors: A Ravaud; S Négrier; L Cany; Y Merrouche; M Le Guillou; J Y Blay; M Clavel; R Gaston; R Oskam; T Philip Journal: Br J Cancer Date: 1994-06 Impact factor: 7.640