Thyroid dysfunction in 281 patients with metastatic melanoma or renal carcinoma treated with interleukin-2 alone.
The purpose of this prospective study was to determine the incidence of thyroid dysfunction in cancer patients receiving immunotherapy with interleukin-2 (IL-2) alone, and to assess the relationship of hypothyroidism to clinical response. A cohort of 281 consecutive patients with metastatic melanoma or renal carcinoma were treated with IL-2 alone from July 1, 1989 until June 30, 1993. The majority (n = 216) received high-dose IL-2 and the remainder (n = 65) received low-dose therapy. Thyroid function was measured before, during, and after immunotherapy. Forty-one percent of initially euthyroid patients developed thyroid dysfunction after starting high-dose IL-2-alone therapy. The most common abnormality was hypothyroidism, occurring in 35% of patients, although moderate or severe hypothyroidism requiring thyroid hormone replacement occurred in 9% of patients. Hypothyroidism was related to duration of IL-2 therapy and was not associated with clinical response. Hyperthyroidism developed in 7% of previously euthyroid patients receiving high-dose IL-2. Overall, the incidence of thyroid dysfunction was similar in the high- and low-dose IL-2 regimens. In conclusion, thyroid dysfunction is a common sequela of IL-2 therapy. Thyroid function should be measured routinely in cancer patients receiving IL-2-based treatment. It is recommended that thyroid hormone replacement be given to patients with moderate or severe hypothyroidism.
Krouse
R S
RS
Surgery Branch, National Cancer Institute, Bethesda, MD 20892, USA.
Royal
R E
RE
Heywood
G
G
Weintraub
B D
BD
White
D E
DE
Steinberg
S M
SM
Rosenberg
S A
SA
Schwartzentruber
D J
DJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced; D007037:Hypothyroidism / Q000139:chemically induced; D016233:Immunotherapy, Active / Q000009:adverse effects; D007376:Interleukin-2 / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000503:physiopathology* / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D011446:Prospective Studies; D013961:Thyroid Gland / Q000503:physiopathology*
D007376:Interleukin-2