Cancer Research and Treatment

Original Articles

The Effect of Immunotherapy Based on Interferon - alpha in Advanced Renal Cell Carcinoma: Seung Hyun Jeon, Sung Goo Chang; J Korean Cancer Assoc. 1999;31(5):986-994.

Abstract PDF: PURPOSE
Recently in light of the development in immunology, interferon- e and inter- leukin-2 or combination therapy with anticancer drugs have been performed. This study aims to verify and compare the efficacy of therapies using interferon- a alone, interferon- a plus vinblastine, and interferon- a plus interleukin-2 plus 5-fluorouracil (5-FU) plus 13-cis retinoic acid (13cRA) in patients with advanced renal cell carcinoma.
MATERIALS AND METHODS
A total of 29 patients were randomly assigned to receive treatment with either interferon- a alone or interferon- a plus vinblastine or interferon- a plus interleukin-2 plus 5-FU plus 13cRA from December 1989 to May 1998. The most frequent metastatic sites were the lung, lymph nodes, bone, liver, and brain. We studied the response rates, survival period, and complications of each regimen.
RESULTS
Responses were achieved in 1 out of 1~5 patients (6.73?o) on interferon- a alone (partial responses lasting 13 months), 1 out of 9 patients (11.1%) on interferon- e plus vinblastine (partial responses lasting 25 months) and 1 out of 5 patients (20.0%) on interferon-a plus IL-2 plus 5-FU plus 13cRA regimen (partial responses lasting 14 months). The median durations of survival were 18, 33, and 23 months respectively. The overall response rate was 10.3% and overall median duration of survival was 19 months. The most common side effects were flu-like symptom such as fever, chills (93.1%), skin symptom such as erythema, pruritus (31.0%), G-I symptom such as nausea, vomiting (17.2%), netropenia (10.3%), abnormal LFT (10.3%), and thrombocytopenia (3.4%).
CONCLUSIONS
This study confirms the manageability and tolerability of several regimen used. There is no significant differences in response rates and survival duration among the regimens used in this study. The effective immunotherapy in patients with metastatic RCC should be evaluated by further studies of larger patients groups even though a minority of patients responded.

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Effect of Combination Chemotherapy with Recombinant Interferon Alpha-2a for Palliative Therapy of metastatic Renal Cell Carcinoma: Jae Cheon Ahn, Seong Choi, Hyun Yul Rhew; J Korean Cancer Assoc. 1996;28(3):555-562.

Abstract PDF: The prognosis for metastatic renal cell carcinoma is poor, and also there is no effective treatment for this cancer. Recombinant interferon alpha-2a displays subadditive. additive, and synergic effects when used with a number of cytotoxic agents is vitro and in vivo tumor models. A total of 3l petients with metastatic renal cell carcinoma was recieved recombinant interferon alpha-2a, vinblastine, CCNU and medroxyprogesterone acetate between March 1988 and December 1993. Their mean age was 53.8 years (range; 14 - 78 years).The male to female ratio was 2.1:1. Histologically, clear cell type was dominant (83.8%).Lung metastasis only was in 13 cases(41.9%) and multiple metastasis was in 18cases.Using the deKerion criteria for response, the response rate was 29%(9 cases). The 1,2,5 year survival rates of all the patients were 48%, 18%, 18% respectively, 100%, 60%, 60% for the responder group and 24%, 8%, 0% for the nonresponder (p=0.004).In combination chemothetherapy with recombinant interferon alpha-2a, the Karnofsky performance index was the most significant prognostic factor(p=0.015). Age, sex, metastatic sites, cell type and disease free interval had no significance(p>0.05).The most common side effects were constitutional symptoms(93.5%).Hematologic toxicity(41.9%),G-I toxicity(41.9%) and hepatic toxicity(6%) occured. In conclusions, combination chemotherapy with recombinant interferon alpha-2a raised remssion and survival rates and can be on effective palliative therapy in patients with metastatic renal cell carcinoma.

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