Intrapleural immunotherapy with escalating doses of interleukin-2 in metastatic pleural effusions.
BACKGROUND
The authors assessed the tolerance and efficacy of intrapleural interleukin-2 (IL-2) in patients with malignant effusion.


METHODS
Twenty-three patients had a total of 25 metastatic pleural effusions; the patients were treated with recombinant IL-2 by means of a continuous intrapleural infusion for 5 days. The daily dosage used in this Phase I/II trial initially was 3 x 10(6) IU/m2/day; the dosage was increased with every third patient, culminating in a dosage of 24 x 10(6) IU/m2/day.


RESULTS
One patient who had received the highest dosage died of renal failure on day 8. Ninety-six percent of patients had Grade 2-3 fever, which was easily controlled with paracetamol administration. Two (8%) patients had pleural empyema. All other side effects were mild and resolved spontaneously by the end of treatment. The objective response rate was 21.7%. The five patients who responded to IL-2 therapy were alive 7-24 months after treatment, and the survival rate of the whole group was 59% after 13 months.


CONCLUSIONS
A daily dose of 10-24 x 10(6) IU/m2/day of IL-2 administered intrapleurally gave response rates similar to those reported in the literature using the intravenous route, but a much lower morbidity rate was recorded.
Institut Paoli-Calmettes, Marseille, France.
J R
JR
Viallat
C
C
Boutin
F
F
Rey
P
P
Astoul
P
P
Farisse
M
M
Brandely
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D004361:Drug Tolerance; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007263:Infusions, Parenteral; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010994:Pleura; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000473:pathology; D011994:Recombinant Proteins; D012074:Remission Induction; D015996:Survival Rate
D007376:Interleukin-2; D011994:Recombinant Proteins