Serum level of interleukin 6 as a prognosis factor in metastatic renal cell carcinoma.
Interleukin (IL) 6 was measured in the serum of 138 patients with metastatic renal carcinoma before the initiation of IL-2 treatment. IL-6 was detectable in 66 patients with renal cancer (48%) and in only 8 of 70 normal adults (11%). Serum C reactive protein (CRP) and IL-6 levels are correlated, suggesting that IL-6 is involved in CRP increase in these patients. The interval between diagnosis of the primary tumor and metastasis was shorter in patients with a detectable serum IL-6 and/or serum CRP level greater than 50 mg/liter. Serum IL-6 and CRP levels were higher in subgroups of patients previously defined as having a poor life expectancy according to the Eastern Cooperative Oncology Group criteria. Pretreatment concentrations of IL-6 and CRP were higher in patients who experienced progressive disease after IL-2 treatment. Patients with detectable IL-6 had a shorter survival from the beginning of IL-2 treatment than patients without circulating IL-6 (median, 8 versus 16 months). Similarly, the median survival from the beginning of IL-2 therapy of patients with CRP levels greater than 50 mg/liter was 6 months, compared to 16 months in those with CRP levels below this threshold. None of the 21 patients with serum IL-6 concentrations greater than 300 pg/ml achieved response to any of the three IL-2 regimens. This subgroup has a median survival of 5 months after IL-2 treatment and consisted of 15% of the patients in our series. These results indicate that serum IL-6 and CRP levels are adverse prognosis factors in patients with metastatic renal cell carcinoma. Serum IL-6 level could help in the selection or stratification of the patients in future IL-2 trials.
Blay
J Y
JY
Departement of Immunology, Centre Léon Bérard, France.
Negrier
S
S
Combaret
V
V
Attali
S
S
Goillot
E
E
Merrouche
Y
Y
Mercatello
A
A
Ravault
A
A
Tourani
J M
JM
Moskovtchenko
J F
JF
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000401:mortality / Q000556:secondary / Q000628:therapy; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000627:therapeutic use; D015850:Interleukin-6 / Q000097:blood*; D007680:Kidney Neoplasms / Q000097:blood* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis
D007376:Interleukin-2; D015850:Interleukin-6; D002097:C-Reactive Protein