Cargando…
Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma
Although tyrosine kinase inhibitors (TKI) are the most common first-line therapy for metastatic renal cell carcinoma, high-dose interleukin-2 (HD-IL2) remains the only agent that provides durable complete responses. The optimal sequence of these agents remains uncertain. This retrospective multi-ins...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127096/ https://www.ncbi.nlm.nih.gov/pubmed/25075565 http://dx.doi.org/10.1097/CJI.0000000000000044 |
_version_ | 1782329992500215808 |
---|---|
author | Lam, Elaine T. Wong, Michael K. K. Agarwal, Neeraj Redman, Bruce G. Logan, Theodore Gao, Dexiang Flaig, Thomas W. Lewis, Karl Poust, Jamie Monk, Paul Jarkowski, Anthony Sendilnathan, Arun Bolden, Marcus Kuzel, Timothy M. Olencki, Thomas |
author_facet | Lam, Elaine T. Wong, Michael K. K. Agarwal, Neeraj Redman, Bruce G. Logan, Theodore Gao, Dexiang Flaig, Thomas W. Lewis, Karl Poust, Jamie Monk, Paul Jarkowski, Anthony Sendilnathan, Arun Bolden, Marcus Kuzel, Timothy M. Olencki, Thomas |
author_sort | Lam, Elaine T. |
collection | PubMed |
description | Although tyrosine kinase inhibitors (TKI) are the most common first-line therapy for metastatic renal cell carcinoma, high-dose interleukin-2 (HD-IL2) remains the only agent that provides durable complete responses. The optimal sequence of these agents remains uncertain. This retrospective multi-institutional study examined the safety and efficacy of HD-IL2 following TKI therapy. After IRB approval at 7 HD-IL2 centers, data relating to patient, disease, and treatment characteristics among 40 consecutive patients with metastatic renal cell carcinoma who were treated with HD-IL2 after at least 1 prior TKI therapy were retrospectively collected. The most common cardiac adverse events were grade 3 hypotension and vascular leak syndrome. Six patients (15%) experienced other grade ≥3 cardiac adverse events. There were 2 treatment-related deaths due to congestive heart failure, occurring in 1 patient with short TKI to HD-IL2 interval and another patient with an abnormal baseline cardiac stress test. Best responses included 2 CRs (5%, duration 40+ and 62+ mo), 3 PRs (8%, duration 6, 11, and 24 mo), 13 SD (32%, median duration 12 mo), 20 PD (50%), and 2 not evaluable patients. Median overall survival was 22 months. Administration of HD-IL2 could be safe and effective after TKI therapy; however, careful selection of patients is critical. We recommend baseline cardiac risk factor assessment, screening with both cardiac stress test and echocardiogram, and allowing a TKI to HD-IL2 interval of at least 2 months. |
format | Online Article Text |
id | pubmed-4127096 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-41270962014-09-19 Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma Lam, Elaine T. Wong, Michael K. K. Agarwal, Neeraj Redman, Bruce G. Logan, Theodore Gao, Dexiang Flaig, Thomas W. Lewis, Karl Poust, Jamie Monk, Paul Jarkowski, Anthony Sendilnathan, Arun Bolden, Marcus Kuzel, Timothy M. Olencki, Thomas J Immunother Clinical Studies Although tyrosine kinase inhibitors (TKI) are the most common first-line therapy for metastatic renal cell carcinoma, high-dose interleukin-2 (HD-IL2) remains the only agent that provides durable complete responses. The optimal sequence of these agents remains uncertain. This retrospective multi-institutional study examined the safety and efficacy of HD-IL2 following TKI therapy. After IRB approval at 7 HD-IL2 centers, data relating to patient, disease, and treatment characteristics among 40 consecutive patients with metastatic renal cell carcinoma who were treated with HD-IL2 after at least 1 prior TKI therapy were retrospectively collected. The most common cardiac adverse events were grade 3 hypotension and vascular leak syndrome. Six patients (15%) experienced other grade ≥3 cardiac adverse events. There were 2 treatment-related deaths due to congestive heart failure, occurring in 1 patient with short TKI to HD-IL2 interval and another patient with an abnormal baseline cardiac stress test. Best responses included 2 CRs (5%, duration 40+ and 62+ mo), 3 PRs (8%, duration 6, 11, and 24 mo), 13 SD (32%, median duration 12 mo), 20 PD (50%), and 2 not evaluable patients. Median overall survival was 22 months. Administration of HD-IL2 could be safe and effective after TKI therapy; however, careful selection of patients is critical. We recommend baseline cardiac risk factor assessment, screening with both cardiac stress test and echocardiogram, and allowing a TKI to HD-IL2 interval of at least 2 months. Lippincott Williams & Wilkins 2014-09 2014-08-13 /pmc/articles/PMC4127096/ /pubmed/25075565 http://dx.doi.org/10.1097/CJI.0000000000000044 Text en Copyright © 2014 by Lippincott Williams & Wilkins This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0. |
spellingShingle | Clinical Studies Lam, Elaine T. Wong, Michael K. K. Agarwal, Neeraj Redman, Bruce G. Logan, Theodore Gao, Dexiang Flaig, Thomas W. Lewis, Karl Poust, Jamie Monk, Paul Jarkowski, Anthony Sendilnathan, Arun Bolden, Marcus Kuzel, Timothy M. Olencki, Thomas Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma |
title | Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma |
title_full | Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma |
title_fullStr | Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma |
title_full_unstemmed | Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma |
title_short | Retrospective Analysis of the Safety and Efficacy of High-dose Interleukin-2 After Prior Tyrosine Kinase Inhibitor Therapy in Patients With Advanced Renal Cell Carcinoma |
title_sort | retrospective analysis of the safety and efficacy of high-dose interleukin-2 after prior tyrosine kinase inhibitor therapy in patients with advanced renal cell carcinoma |
topic | Clinical Studies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127096/ https://www.ncbi.nlm.nih.gov/pubmed/25075565 http://dx.doi.org/10.1097/CJI.0000000000000044 |
work_keys_str_mv | AT lamelainet retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT wongmichaelkk retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT agarwalneeraj retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT redmanbruceg retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT logantheodore retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT gaodexiang retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT flaigthomasw retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT lewiskarl retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT poustjamie retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT monkpaul retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT jarkowskianthony retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT sendilnathanarun retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT boldenmarcus retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT kuzeltimothym retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma AT olenckithomas retrospectiveanalysisofthesafetyandefficacyofhighdoseinterleukin2afterpriortyrosinekinaseinhibitortherapyinpatientswithadvancedrenalcellcarcinoma |