title: Clinical and safety profile of high-dose interleukin-2 treatment in elderly patients with metastatic melanoma and renal cell carcinoma.
abstract: OBJECTIVE
  High-dose interleukin-2 (IL-2) is effective immunotherapy for the treatment of metastatic melanoma and renal cell carcinoma (RCC) but has been contraindicated in elderly patients. This study assessed the safety and therapeutic efficacy of high-dose IL-2 in patients ≥65 years of age with metastatic melanoma and RCC.
  
  
  METHODS
  A prospectively collected clinical database of 104 consecutive melanoma or RCC patients treated with high-dose IL-2 between 2009 and 2012 was used to compare clinical outcomes and adverse events in patients ≥65 years of age with those of younger patients.
  
  
  RESULTS
  There were 22 (21%) patients ≥65 years and 82 (79%) patients <65 years of age. The mean number of IL-2 doses was lower in older patients during cycle 1 of treatment (7.2 vs. 8.6, p = 0.012). There were no other differences in dosing pattern by age group. There was a higher rate of selected cardiac, constitutional, hematologic, metabolic and renal toxicities in younger patients (p < 0.05). Overall, objective responses and survival were not affected by age, though older patients had a higher partial response rate (p = 0.04).
  
  
  CONCLUSIONS
  IL-2 is safe and has comparable therapeutic effectiveness in patients ≥65 years. Age should not be considered a contraindication to treatment with IL-2 in otherwise eligible patients.
authors.affiliation: Department of General Surgery, Rush University Medical Center, Chicago, IL 60612, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Clark
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kelley
authors.forename: Jill
authors.initials: J
authors.lastname: Titze
authors.forename: Henry
authors.initials: H
authors.lastname: Fung
authors.forename: John
authors.initials: J
authors.lastname: Maciejewski
authors.forename: Sunita
authors.initials: S
authors.lastname: Nathan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rich
authors.forename: Sanjib
authors.initials: S
authors.lastname: Basu
authors.forename: Howard L
authors.initials: HL
authors.lastname: Kaufman
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007376:Interleukin-2 / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D007376:Interleukin-2