title: Combined subcutaneous recombinant alpha-interferon and interleukin-2 in metastatic renal cell cancer: results of the Multicentre All Ireland Immunotherapy Study Group.
abstract: OBJECTIVE
  To analyse the toxicity and efficacy of combined interferon-alpha and interleukin-2, administered subcutaneously in a general multicentre setting, as treatment for metastatic renal cell carcinoma.
  
  
  METHODS
  Thirty-three patients with metastatic renal cell carcinoma were scheduled to receive 2 cyclical doses of subcutaneous interferon-alpha (week 1: 5 MU x 3 days) and interleukin-2 (week 2: 36 MU x 2 days, 9 MU x 3 days; weeks 3-5: 9 MU daily). Karnofsky scores ranged from 80 to 100 (median 90). Metastases occurred in multiple organs (lung 63%, retroperitoneal 39%, liver 24%). Patients were categorised according to the risk of disease progression. Treatment toxicity, therapeutic response and actuarial survival were analysed.
  
  
  RESULTS
  All patients received recommended doses of treatment, but 6 received less than 2 cycles. Most were treated as outpatients, although hospitalisation was usual during the 1st week of a cycle. All complained of mild flu-like symptoms. Severe side effects developed in 13 patients (39%), and treatment was discontinued in 3 of these patients. No deaths occurred as a result of treatment. The overall median survival was 10 months. The overall actuarial survival rate at 3 years was 22%. On statistical analysis, actuarial survival rates were not influenced by either response to treatment or risk group category.
  
  
  CONCLUSIONS
  Subcutaneously administered, combined interferon-alpha and interleukin-2 therapy achieves durable survival rates in a minority of patients with renal cell carcinoma. Toxicity is remedial, and not fatal, when subcutaneous therapy is administered by multiple medical disciplines at a variety of centres.
authors.affiliation: The Adelaide and Meath Hospital, Dublin, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Rogers
authors.forename: H
authors.initials: H
authors.lastname: Bredin
authors.forename: M
authors.initials: M
authors.lastname: Butler
authors.forename: M
authors.initials: M
authors.lastname: Corcoran
authors.forename: E
authors.initials: E
authors.lastname: Egan
authors.forename: J
authors.initials: J
authors.lastname: Fennelly
authors.forename: R
authors.initials: R
authors.lastname: Grainger
authors.forename: S M
authors.initials: SM
authors.lastname: Aleer
authors.forename: T M
authors.initials: TM
authors.lastname: Dermott
authors.forename: G
authors.initials: G
authors.lastname: Mullins
authors.forename: A
authors.initials: A
authors.lastname: Tanner
authors.forename: A
authors.initials: A
authors.lastname: Twomey
authors.forename: J
authors.initials: J
authors.lastname: Thornhill
mesh_terms: D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007370:Interferon Type I / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D007370:Interferon Type I; D007376:Interleukin-2; D011994:Recombinant Proteins