Phase I study of recombinant human interleukin-7 administration in subjects with refractory malignancy.
OBJECTIVE
Interleukin-7 (IL-7) has critical and nonredundant roles in T-cell development, hematopoiesis, and postdevelopmental immune functions as a prototypic homeostatic cytokine. Based on a large body of preclinical evidence, it may have multiple therapeutic applications in immunodeficiency states, either physiologic (immunosenescence), pathologic (HIV), or iatrogenic (postchemotherapy and posthematopoietic stem cell transplant), and may have roles in immune reconstitution or enhancement of immunotherapy. We report here on the toxicity and biological activity of recombinant human IL-7 (rhIL-7) in humans.


METHODS
Subjects with incurable malignancy received rhIL-7 subcutaneously every other day for 2 weeks in a phase I interpatient dose escalation study (3, 10, 30, and 60 microg/kg/dose). The objectives were safety and dose-limiting toxicity determination, identification of a range of biologically active doses, and characterization of biological and, possibly, antitumor effects.


RESULTS
Mild to moderate constitutional symptoms, reversible spleen and lymph node enlargement, and marked increase in peripheral CD3(+), CD4(+), and CD8(+) lymphocytes were seen in a dose-dependent and age-independent manner in all subjects receiving >or=10 microg/kg/dose, resulting in a rejuvenated circulating T-cell profile, resembling that seen earlier in life. In some subjects, rhIL-7 induced in the bone marrow a marked, transient polyclonal proliferation of pre-B cells showing a spectrum of maturation as well as an increase in circulating transitional B cells.


CONCLUSIONS
This study shows the potent biological activity of rhIL-7 in humans over a well-tolerated dose range and allows further exploration of its possible therapeutic applications.
Sportès
Claude
C
Experimental Transplantation and Immunology Branch, National Cancer Institute, NIH, Bethesda, Maryland 20892-1203, USA. csportes@mail.nih.gov
Babb
Rebecca R
RR
Krumlauf
Michael C
MC
Hakim
Frances T
FT
Steinberg
Seth M
SM
Chow
Catherine K
CK
Brown
Margaret R
MR
Fleisher
Thomas A
TA
Noel
Pierre
P
Maric
Irina
I
Stetler-Stevenson
Maryalice
M
Engel
Julie
J
Buffet
Renaud
R
Morre
Michel
M
Amato
Robert J
RJ
Pecora
Andrew
A
Mackall
Crystal L
CL
Gress
Ronald E
RE
D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D001772:Blood Cell Count; D001854:Bone Marrow Cells / Q000187:drug effects / Q000473:pathology; D017252:CD3 Complex / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism / Q000473:pathology; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D006801:Humans; D015851:Interleukin-7 / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D016879:Salvage Therapy; D055815:Young Adult
D017252:CD3 Complex; C508605:IL7 protein, human; D015851:Interleukin-7; D011994:Recombinant Proteins