title: Management of toxicities associated with high-dose interleukin-2 and biochemotherapy.
abstract: High-dose interleukin-2, administered as a single agent or in combination with antineoplastic agents, known as biochemotherapy, holds the promise of durable remissions for patients with metastatic renal cell carcinoma and metastatic melanoma. The toxicities arising from high-dose interleukin-2-based therapies affect every organ system, causing significant acute morbidity. Administration of high-dose interleukin-2-based therapies requires specialized care and knowledge because of the severity and uniqueness of toxicities compared with the toxicities encountered with other forms of anticancer therapy. However, the toxicities of high-dose interleukin-2-based therapies are predictable and manageable by vigilant monitoring and appropriate supportive care protocols. To maximize outcomes, both acute and delayed toxicities require vigilant monitoring and adroit symptom management. This review details the pathophysiology, monitoring parameters, and management strategies for patients receiving high-dose interleukin-2-based therapy, with a focus on new and important management principles.
authors.affiliation: Department of Pharmacy, University of Colorado Hospital, Aurora, Colorado, USA.
authors.forename: Jamie C
authors.initials: JC
authors.lastname: Poust
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Woolery
authors.forename: Myke R
authors.initials: MR
authors.lastname: Green
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D009362:Neoplasm Metastasis; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology; D013997:Time Factors
chemical_list: D007376:Interleukin-2