title: Combined treatment with low-dose interferon plus vinblastine is associated with less toxicity than conventional interferon monotherapy in patients with metastatic renal cell carcinoma.
abstract: The outcome of treatment of advanced renal cell carcinoma is disappointing. In interferon (IFN)-treated patients, the high incidence of adverse effects causes many patients to withdraw from treatment. This 12-week randomized study compared the incidence of toxicity associated with high-dose IFN monotherapy (15 x 10(6) U thrice weekly) and treatment with the combination of low-dose IFN (5 x 10(6) U thrice weekly) and 6 mg/m2 vinblastine (VBL) every 14 days in 100 consecutive patients. There was no significant difference in response rate between treatment arms (42% IFN vs. 34% IFN + VBL) or between subgroups (by tumor location). Combined treatment was associated with a significantly lower incidence of fever, fatigue, and weight loss but with a higher incidence of leukopenia. There was no significant difference in the incidence of other events. More patients treated with IFN monotherapy required bed rest, and overall treatment costs were 60% higher than for combined treatment. It is concluded that combined treatment with low-dose IFN and VBL, without loss of short-term efficacy, is better tolerated and less expensive than high-dose IFN monotherapy.
authors.affiliation: Department of Pathophysiology, Laiko General Hospital, University of Athens, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Tsavaris
authors.forename: D
authors.initials: D
authors.lastname: Skarlos
authors.forename: C
authors.initials: C
authors.lastname: Bacoyiannis
authors.forename: G
authors.initials: G
authors.lastname: Aravantinos
authors.forename: C
authors.initials: C
authors.lastname: Kosmas
authors.forename: G
authors.initials: G
authors.lastname: Retalis
authors.forename: C
authors.initials: C
authors.lastname: Panopoulos
authors.forename: M
authors.initials: M
authors.lastname: Vadiaka
authors.forename: A
authors.initials: A
authors.lastname: Dimitrakopoulos
authors.forename: K
authors.initials: K
authors.lastname: Kostantinidis
authors.forename: D
authors.initials: D
authors.lastname: Mitropoulos
authors.forename: D
authors.initials: D
authors.lastname: Bougas
authors.forename: D
authors.initials: D
authors.lastname: Pantazopoulos
authors.forename: P
authors.initials: P
authors.lastname: Kosmidis
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects* / Q000191:economics; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D003365:Costs and Cost Analysis; D004361:Drug Tolerance; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects* / Q000191:economics; D007680:Kidney Neoplasms / Q000188:drug therapy*; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D014747:Vinblastine / Q000008:administration & dosage* / Q000009:adverse effects* / Q000191:economics; D015431:Weight Loss / Q000187:drug effects
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D014747:Vinblastine