Intrapleural treatment with recombinant gamma-interferon in early stage malignant pleural mesothelioma.
BACKGROUND
This report presents the results of a prospective multi-institutional study of intrapleural treatment with gamma-interferon in patients with Butchart's Stages I and II epithelial or mixed malignant pleural mesothelioma.


METHODS
Interferon was administered at a dose of 40 million units twice a week for 8 weeks intrapleurally via a catheter or an implantable port. Thoracoscopic or surgical biopsy was performed if computed tomography scan 2 weeks after the end of treatment demonstrated a reduction in tumor size. Survival was calculated after a follow-up of at least 18 months. Prognostic factors were identified by univariate and multivariate analyses (Cox model).


RESULTS
Eighty-nine patients were included over 46 months. Eight histologically confirmed complete responses and nine partial responses with at least a 50% reduction in tumor size were obtained. The overall response rate was 20%. Most responses were achieved in patients with early stage disease. The response rate for patients with Stage I disease was 45%. Tolerance of interferon was good. Treatment was performed on an outpatient basis. The main side effects were hyperthermia, liver toxicity, neutropenia, and catheter-related infection.


CONCLUSIONS
Gamma-interferon is effective mainly in Stage I mesothelioma, especially if the tumor is confined to the parietal or diaphragmatic pleura (Stage IA).
Boutin
C
C
Hôpital de la Conception, Marseille, France.
Nussbaum
E
E
Monnet
I
I
Bignon
J
J
Vanderschueren
R
R
Guerin
J C
JC
Menard
O
O
Mignot
P
P
Dabouis
G
G
Douillard
J Y
JY
D000368:Aged; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007371:Interferon-gamma / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008654:Mesothelioma / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D011994:Recombinant Proteins; D012074:Remission Induction; D016019:Survival Analysis
D011994:Recombinant Proteins; D007371:Interferon-gamma