title: Kidney cancer: the Cytokine Working Group experience (1986-2001): part II. Management of IL-2 toxicity and studies with other cytokines.
abstract: The Cytokine Working Group (CWG) was initially established in 1986 as the Extramural IL-2/LAK Working Group. With funding from the National Cancer Institute (NCI), the CWG was mandated to confirming data regarding the efficacy of the high-dose interleukin-2 (IL2)/lymphokine-activated killer cell (LAK cell) regimen piloted at the NCI in the treatment of renal cell cancer. Since those initial studies, the CWG has conducted a series of clinical trials, often with correlative immunologic investigations, to evaluate combination immunotherapy in attempts to enhance the efficacy of IL-2 or to reduce toxicity. Subsequently, the CWG conducted trials to demonstrate the activity of lower-dose outpatient combination cytokine regimens to help determine their role in the armamentarium of treatment for metastatic renal cell cancer. This has culminated in a phase III randomized trial comparing the activity of high-dose IL-2 with the activity of outpatient IL-2 plus interferon-alpha. The CWG also has honed the management of both high-dose IL-2 and outpatient IL-2 regimens to make these safer in the hands of experienced clinicians. In addition, the CWG has produced a series of carefully conducted clinical trials of new cytokines, again attempting to define their clinical efficacy as anticancer agents. These include studies of IL-4, IL-6, and IL-12. Currently, the CWG is conducting studies with new approaches to IL-2 therapy, as well as planning trials with new agents for treatment of renal cell cancer. This review describes these efforts conducted over the past 15 yr.
authors.affiliation: Our Lady of Mercy/New York Medical College, Bronx 10466, USA. jpd4401@aol.com
authors.forename: J
authors.initials: J
authors.lastname: Dutcher
authors.forename: M B
authors.initials: MB
authors.lastname: Atkins
authors.forename: K
authors.initials: K
authors.lastname: Margolin
authors.forename: G
authors.initials: G
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Clark
authors.forename: J
authors.initials: J
authors.lastname: Sosman
authors.forename: T
authors.initials: T
authors.lastname: Logan
authors.forename: F
authors.initials: F
authors.lastname: Aronson
authors.forename: J
authors.initials: J
authors.lastname: Mier
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000276:immunology; D016207:Cytokines / Q000494:pharmacology* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D006801:Humans; D016898:Interferon-alpha / Q000494:pharmacology; D007376:Interleukin-2 / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000276:immunology; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic
chemical_list: D000970:Antineoplastic Agents; D016207:Cytokines; D016898:Interferon-alpha; D007376:Interleukin-2