Progress report on the palliative therapy of 100 patients with neoplastic effusions by intracavitary low-dose interleukin-2.
OBJECTIVE
Several cytokines, particularly IL-2 and interferons, are thought to be effective in the palliative therapy of neoplastic effusions. We report on the activity and toxicity of intracavitary administration of low-dose IL-2 in a case series of 100 cancer patients with neoplastic effusions.


METHODS
One hundred patients with advanced solid tumors and neoplastic effusions underwent IL-2 intracavitary injection as first-line treatment. The most common sites of fluid accumulation were pleura (n = 68), peritoneum (n = 21) and pericardium (n = 11). Breast cancer, lung cancer and mesothelioma were the most frequent neoplasms in our series. One cycle consisted of intracavitary IL-2 at 6,000,000 IU on days 1 and 7.


RESULTS
According to Paladine's criteria, an objective clinical response was achieved in 72% (complete response in 27% and partial response in 45%), with a median duration of 5 months (range: 1-11 months). The peritoneum was the least responsive site for neoplastic effusion reduction. IL-2 intracavitary injection was well tolerated in all patients; the only toxicity observed was fever >38 degrees C in 6% of the patients.


CONCLUSIONS
This study shows that intracavitary injection of IL-2 represents a feasible, well-tolerated and effective therapy of neoplastic fluid accumulation. Further studies are needed in order to compare the effectiveness of intracavitary IL-2 with other standard treatments.
Lissoni
P
P
Division of Radiation Oncology, S. Gerardo Hospital, Monza, Italy.
Mandalà
M
M
Curigliano
G
G
Ferretti
G
G
Moro
C
C
Ardizzoia
A
A
Malugani
F
F
Tancini
G
G
Tisi
E
E
Arrigoni
C
C
Barni
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000378:metabolism; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007376:Interleukin-2 / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D010166:Palliative Care; D010996:Pleural Effusion / Q000378:metabolism; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome
D007376:Interleukin-2