PURPOSE: This article analyzes the long-term results of 203 consecutive patients with metastatic renal cell carcinoma who were treated with various recombinant interleukin-2 (rIL-2) -based immunotherapy regimens, and describes factors that may influence response to therapy and long-term survival. PATIENTS AND METHODS: The response and survival of 203 patients with metastatic renal cell carcinoma treated consecutively between July 1987 and October 1995 at the UCLA Medical Center Kidney Cancer Program with rIL-2-based immunotherapy were analyzed. Patients were divided into four groups: (1) no prior nephrectomy (n = 24), (2) nephrectomy > 6 months prior to rIL-2 therapy (n = 76), (3) nephrectomy < or = 6 months prior to rIL-2 therapy (n = 47), and (4) nephrectomy followed by treatment with rIL-2 and tumor-infiltrating lymphocytes +/- interferon-alpha (n = 56). Response and survival for each of these patient groups and survival per response to therapy were compared. RESULTS: The overall median survival for all patients was 18 months, and survival at 1, 2, and 3 years after therapy was 61%, 40%, and 31% percent, respectively. A total of 12 patients (6%) achieved a complete response, and all were alive at 3 years. Of 36 patients (18%) who achieved a partial response and 41 patients (20%) with stable disease, 3-year survival was 37% and 50%, respectively. The survival of patients with a partial response or stable disease was significantly better than that of patients who exhibited progressive disease. Patients with nephrectomy > 6 months prior to rIL-2 therapy had a 46% 3-year survival rate, compared with a 9% 3-year survival rate for patients with nephrectomy < or = 6 months prior to rIL-2 therapy and a 4% 3-year survival rate for patients with no nephrectomy. Patients treated with tumor-infiltrating lymphocytes had a 38% 3-year survival rate, which was also significantly better than patients treated with nephrectomy < or = 6 months prior to rIL-2 therapy or with no nephrectomy. CONCLUSION: This analysis demonstrated that rIL-2-based therapy offers a significant survival benefit to patients with advanced metastatic renal cell carcinoma, compared with historical controls. Furthermore, we have shown that nephrectomy > 6 months prior to rIL-2 therapy and nephrectomy followed by treatment with tumor-infiltrating lymphocytes/rIL-2 +/- interferon-alpha was associated with the greatest survival benefit. Tumor response to rIL-2-based therapy and time from nephrectomy to treatment were the most important predictors of survival. Randomized studies in a large group of patients are needed to confirm these observations.
PURPOSE: This article analyzes the long-term results of 203 consecutive patients with metastatic renal cell carcinoma who were treated with various recombinant interleukin-2 (rIL-2) -based immunotherapy regimens, and describes factors that may influence response to therapy and long-term survival. PATIENTS AND METHODS: The response and survival of 203 patients with metastatic renal cell carcinoma treated consecutively between July 1987 and October 1995 at the UCLA Medical Center Kidney Cancer Program with rIL-2-based immunotherapy were analyzed. Patients were divided into four groups: (1) no prior nephrectomy (n = 24), (2) nephrectomy > 6 months prior to rIL-2 therapy (n = 76), (3) nephrectomy < or = 6 months prior to rIL-2 therapy (n = 47), and (4) nephrectomy followed by treatment with rIL-2 and tumor-infiltrating lymphocytes +/- interferon-alpha (n = 56). Response and survival for each of these patient groups and survival per response to therapy were compared. RESULTS: The overall median survival for all patients was 18 months, and survival at 1, 2, and 3 years after therapy was 61%, 40%, and 31% percent, respectively. A total of 12 patients (6%) achieved a complete response, and all were alive at 3 years. Of 36 patients (18%) who achieved a partial response and 41 patients (20%) with stable disease, 3-year survival was 37% and 50%, respectively. The survival of patients with a partial response or stable disease was significantly better than that of patients who exhibited progressive disease. Patients with nephrectomy > 6 months prior to rIL-2 therapy had a 46% 3-year survival rate, compared with a 9% 3-year survival rate for patients with nephrectomy < or = 6 months prior to rIL-2 therapy and a 4% 3-year survival rate for patients with no nephrectomy. Patients treated with tumor-infiltrating lymphocytes had a 38% 3-year survival rate, which was also significantly better than patients treated with nephrectomy < or = 6 months prior to rIL-2 therapy or with no nephrectomy. CONCLUSION: This analysis demonstrated that rIL-2-based therapy offers a significant survival benefit to patients with advanced metastatic renal cell carcinoma, compared with historical controls. Furthermore, we have shown that nephrectomy > 6 months prior to rIL-2 therapy and nephrectomy followed by treatment with tumor-infiltrating lymphocytes/rIL-2 +/- interferon-alpha was associated with the greatest survival benefit. Tumor response to rIL-2-based therapy and time from nephrectomy to treatment were the most important predictors of survival. Randomized studies in a large group of patients are needed to confirm these observations.
Authors: Martin E Gore; Clare L Griffin; Barry Hancock; Poulam M Patel; Lynda Pyle; Michael Aitchison; Nicholas James; Roderick T D Oliver; Jozef Mardiak; Tahera Hussain; Richard Sylvester; Mahesh K B Parmar; Patrick Royston; Peter F A Mulders Journal: Lancet Date: 2010-02-10 Impact factor: 79.321
Authors: Thinle Chodon; Begoña Comin-Anduix; Bartosz Chmielowski; Richard C Koya; Zhongqi Wu; Martin Auerbach; Charles Ng; Earl Avramis; Elizabeth Seja; Arturo Villanueva; Tara A McCannel; Akira Ishiyama; Johannes Czernin; Caius G Radu; Xiaoyan Wang; David W Gjertson; Alistair J Cochran; Kenneth Cornetta; Deborah J L Wong; Paula Kaplan-Lefko; Omid Hamid; Wolfram Samlowski; Peter A Cohen; Gregory A Daniels; Bijay Mukherji; Lili Yang; Jerome A Zack; Donald B Kohn; James R Heath; John A Glaspy; Owen N Witte; David Baltimore; James S Economou; Antoni Ribas Journal: Clin Cancer Res Date: 2014-03-14 Impact factor: 12.531
Authors: David F McDermott; Su-Chun Cheng; Sabina Signoretti; Kim A Margolin; Joseph I Clark; Jeffrey A Sosman; Janice P Dutcher; Theodore F Logan; Brendan D Curti; Marc S Ernstoff; Leonard Appleman; Michael K K Wong; Nikhil I Khushalani; Leslie Oleksowicz; Ulka N Vaishampayan; James W Mier; David J Panka; Rupal S Bhatt; Alexandra S Bailey; Bradley C Leibovich; Eugene D Kwon; Fairooz F Kabbinavar; Arie S Belldegrun; Robert A Figlin; Allan J Pantuck; Meredith M Regan; Michael B Atkins Journal: Clin Cancer Res Date: 2014-11-25 Impact factor: 12.531