title: Single institution experience with recombinant gamma-interferon in the treatment of patients with metastatic renal cell carcinoma.
abstract: We report the clinical course of eight patients with metastatic renal cell carcinoma (RCC) who were treated with recombinant gamma-interferon (Immuneron) as part of a phase II-III study comparing the safety and efficacy of gamma-interferon with that of medroxyprogesterone acetate (Depo-Provera). There were no objective responders among the eight patients treated with recombinant gamma-interferon at an i.v. dose of 1 mg/m(2) daily for five days every other week for four weeks then 1 mg/m(2) three times a week given every other week until there was documented disease progression or complete response (CR). Overall median survival was 17.3 months (range 1.4 to 184). The major side effects of treatment included fever/chills (75%), mild anorexia and fatigue (75%), nausea/vomiting (80%), leukopenia (38%), and abnormal liver function tests (25%). There were no life-threatening side effects observed. At our institution, in a random cohort of eight patients with metastatic RCC, recombinant gamma-interferon when given at a dose of 1 mg/m(2) per day given three times per week on an every other week schedule yields no clinical antitumor activity. A review of the literature on the use of gamma-interferon for metastatic RCC suggests that low-dose combination therapy with other cytokines may yield the best response-to-side effect ratio. Higher doses yield more responses but an added cost of more toxicity.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: S
authors.initials: S
authors.lastname: Mani
authors.forename: W J
authors.initials: WJ
authors.lastname: Poo
mesh_terms: D000328:Adult; D000368:Aged; D000855:Anorexia / Q000209:etiology; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy*; D015331:Cohort Studies; D018450:Disease Progression; D005221:Fatigue / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007275:Injections, Intravenous; D007371:Interferon-gamma / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000628:therapy*; D007970:Leukopenia / Q000209:etiology; D008297:Male; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D011994:Recombinant Proteins; D012074:Remission Induction; D015996:Survival Rate; D014839:Vomiting / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D011994:Recombinant Proteins; D007371:Interferon-gamma; D017258:Medroxyprogesterone Acetate