Immunotherapy in Patients with Less than Complete Response to Chemotherapy

• Published in: Anticancer research Vol. 29; no. 2; pp. 567 - 572
• Main Authors: RECCHIA, Francesco, CANDELORO, Giampiero, NECOZIONE, Stefano, BISEGNA, Roberta, BRATTA, Massimo, REA, Silvio
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.02.2009
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Drug Interactions; Drug Resistance, Neoplasm; Female; Humans; Immunotherapy - methods; Interleukin-2 - administration & dosage; Interleukin-2 - therapeutic use; Isotretinoin - administration & dosage; Isotretinoin - therapeutic use; Male; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms - blood; Neoplasms - drug therapy; Neoplasms - immunology; Neoplasms - therapy; Tumors; Vascular Endothelial Growth Factor A - blood; Human; Solid tumor; Chemotherapy; Cancerology; Treatment; Partial; Immunotherapy; stable disease; Malignant tumor; partial response; solid tumors; Cancer
• ISSN: 0250-7005; 1791-7530

Background: Patients with metastatic solid tumors (MST) with less than a complete response to chemotherapy (L-CR), a depressed immune system and elevated serum vascular endothelial growth factor (VEGF) lack defined treatment options. The primary endpoint evaluated in this study was whether interleukin-2 (IL-2) and 13-cisretinoic acid (RA) treatment reduced VEGF and improved immune function in such patients. Secondary endpoints were objective response, relapse-free survival (RFS), and overall survival (OS). Patients and Methods: One hundred consecutive MST patients with L-CR and a mean serum VEGF of 421.0 pg/mm 3 were enrolled. Patients self-administered subcutaneous IL-2 1.8×10 6 IU/day, and oral RA 0.5 mg/kg/day × 5 days/week for 2 cycles of 3 weeks/month for 1 year and continued until progression. Results: After a median follow-up of 78 months, a statistically significant VEGF decrease and improvements in lymphocyte, NK, and CD4 + /CD8 + ratio were observed. Twenty-four patients were converted to a CR; their 5-year RFS and OS rates were each 96% . No WHO grade 3 or 4 toxicities were observed. Conclusion: Administration of IL-2/RA to this patient population produced a significant decrease in VEGF, improvement of prognostically relevant immunological parameters, and durable response in 25% of patients.