Treatment of carcinoid syndrome with recombinant interferon alpha-2a

• Published in: Acta oncologica Vol. 32; no. 2; p. 235
• Main Authors: Di Bartolomeo, M, Bajetta, E, Zilembo, N, de Braud, F, Di Leo, A, Verusio, C, D'Aprile, M, Scanni, A, Barduagni, M, Barduagni A [corrected to Barduagni, M ]
• Format: Journal Article
• Language: English
• Published: England 1993
• Subjects: Adult; Aged; Carcinoid Tumor - drug therapy; Carcinoid Tumor - secondary; Carcinoid Tumor - urine; Drug Administration Schedule; Female; Humans; Hydroxyindoleacetic Acid - urine; Injections, Intramuscular; Interferon-alpha - adverse effects; Interferon-alpha - therapeutic use; Male; Malignant Carcinoid Syndrome - drug therapy; Malignant Carcinoid Syndrome - urine; Middle Aged; Recombinant Proteins
• ISSN: 0284-186X
• DOI: 10.3109/02841869309083918

The prognosis and the quality of life of patients with carcinoid tumors is related either to symptoms from the substances secreted or to progressive tumor growth. Medical treatment with cytotoxic agents is of marginal value for increasing life expectancy and reducing clinical symptoms. Recent studies with interferon have shown interesting results. In the present investigation, 22 patients with carcinoid tumors and syndrome were treated with recombinant interferon alpha-2a (r-IFN alpha-2a) at the dose of 6 x 10(6) IU intramuscularly daily for 8 weeks and three times weekly thereafter. The primary tumor was localized in the foregut (n = 11), midgut (n = 7), hindgut (n = 1), and unknown site (n = 3). Most cases had liver metastasis. Seventeen patients had elevated 5-hydroxyindoloacetic acid (5-HIAA) excretion and 5 had flushing and/or diarrhea as the only clinical manifestation. Six cases presented a complete syndrome (flushing, diarrhea and 5-HIAA excretion). Control of symptoms was obtained in 80% and a 5-HIAA level reduction in 58% of the patients. The interferon treatment was more effective for control of the carcinoid syndrome than for control of tumor growth. The treatment was well tolerated and fever, myalgia, anorexia and fatigue were the most frequent side-effects.