Activity of subcutaneous interleukin-12 in AIDS-related Kaposi sarcoma.
Interleukin-12 (IL-12) enhances Th1-type T-cell responses and exerts antiangiogenic effects. We initiated a phase 1 pilot study of IL-12 in 32 patients with acquired immunodeficiency syndrome (AIDS)-related Kaposi sarcoma (KS) whose KS was progressing while on antiretroviral therapy. Fifteen patients had poor prognosis T(1)S(1) disease. IL-12 was administered subcutaneously twice weekly at doses from 100 to 625 ng/kg. The maximum tolerated dose was 500 ng/kg, and the principal toxicities were flulike symptoms, transaminase or bilirubin elevations, neutropenia, hemolytic anemia, and depression. No tumor responses were seen at the lowest dose (100 ng/kg), but 17 of 24 evaluable patients at the higher doses had partial or complete responses (response rate, 71%; 95% confidence interval, 48%-89%). Only 3 of 17 patients had a change in antiretroviral therapy before responding, and there were no significant differences between responders and nonresponders with regard to changes in CD4 counts or viral loads. Patients had increases in their serum IL-12, interferon-gamma, and inducible protein-10 (IP-10) after the first dose, and increases above baseline persisted after week 4. These results provide preliminary evidence that IL-12 has substantial activity against AIDS-related KS with acceptable toxicity and warrants further investigation for this indication.
Little
Richard F
RF
HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1868, USA.
Pluda
James M
JM
Wyvill
Kathleen M
KM
Rodriguez-Chavez
Isaac R
IR
Tosato
Giovanna
G
Catanzaro
Andrew T
AT
Steinberg
Seth M
SM
Yarchoan
Robert
R
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000743:Anemia, Hemolytic / Q000097:blood / Q000139:chemically induced; D044966:Anti-Retroviral Agents / Q000008:administration & dosage; D018791:CD4 Lymphocyte Count; D054357:Chemokine CXCL10; D019743:Chemokines, CXC / Q000097:blood; D003863:Depression / Q000097:blood / Q000139:chemically induced; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000097:blood / Q000139:chemically induced; D007279:Injections, Subcutaneous; D007371:Interferon-gamma / Q000097:blood; D018664:Interleukin-12 / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D010865:Pilot Projects; D012074:Remission Induction; D012514:Sarcoma, Kaposi / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000637:Transaminases / Q000097:blood; D019562:Viral Load
D044966:Anti-Retroviral Agents; C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; D019743:Chemokines, CXC; D018664:Interleukin-12; D007371:Interferon-gamma; D000637:Transaminases