title: Low-dose inhalation of interleukin-2 bio-chemotherapy for the treatment of pulmonary metastases in melanoma patients.
abstract: BACKGROUND
  Interleukin-2 (IL-2) treatment for patients with metastatic melanoma has shown remarkable durable responses. Systemic administration of IL-2 may cause severe side effects, whereas local administration is considered to be a safe alternative. The lungs are common sites of metastases in melanoma patients causing considerable respiratory problems. We sought to evaluate the potential antitumoral effect of a low-dose inhalative IL-2 (lh-IL-2) regimen for patients with melanoma lung metastases. In addition, we explored the prophylactic potential of Ih-IL-2 after surgical removal of lung metastases in a study carried out in an outpatient setting.
  
  
  METHODS
  Twenty patients with American Joint Committee on Cancer stage-IV (M1b and M1c) melanoma were enrolled in this study and treated with 3 × 3 million IU inhalative IL-2 q.d. together with monthly dacarbazine bolus injections. Five patients received lh-IL-2 after surgical resection of lung metastases to prevent recurrence of the disease (prophylaxis group, N=5). All other patients were enrolled in the treatment group (N=15). Clinical evaluations were carried out monthly and radiological follow-up was performed every third month.
  
  
  RESULTS
  Nine patients in the treatment group had a clinical benefit with partial regression (27%) or stable disease (33%). Four patients had progression of lung metastases (26.7%) and two patients were not evaluable (13.3%). In the prophylaxis group, none of the patients developed new lung metastases during lh-IL-2 therapy. The median follow-up period was 7.8 months in the treatment group and 25.7 months in the prophylaxis group. In the majority of patients, treatment was well tolerated.
  
  
  CONCLUSIONS
  Low-dose IL-2 inhalation might offer an effective and safe treatment option for lung metastases in melanoma patients. In addition, lh-IL-2 may have a prophylactic potential to prevent recurrence in the lungs after pulmonary melanoma metastasectomy. Administration can easily be performed in an outpatient setting, thus offering an attractive treatment option.
authors: 1] Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Juchgasse 25, 1030 Vienna, Austria [2] Department of Dermatology, Mt Zion Cancer Research Center, University of California, 2340 Sutter Street N461, 94115 San Francisco, CA, USA.
authors: C
authors: C
authors: Posch
authors: Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Juchgasse 25, 1030 Vienna, Austria.
authors: F
authors: F
authors: Weihsengruber
authors: Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Juchgasse 25, 1030 Vienna, Austria.
authors: K
authors: K
authors: Bartsch
authors: Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Juchgasse 25, 1030 Vienna, Austria.
authors: V
authors: V
authors: Feichtenschlager
authors: 1] Department of Dermatology, Mt Zion Cancer Research Center, University of California, 2340 Sutter Street N461, 94115 San Francisco, CA, USA [2] Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
authors: M
authors: M
authors: Sanlorenzo
authors: Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Juchgasse 25, 1030 Vienna, Austria.
authors: I
authors: I
authors: Vujic
authors: Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Juchgasse 25, 1030 Vienna, Austria.
authors: B
authors: B
authors: Monshi
authors: Department of Dermatology, Mt Zion Cancer Research Center, University of California, 2340 Sutter Street N461, 94115 San Francisco, CA, USA.
authors: S
authors: S
authors: Ortiz-Urda
authors: Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Juchgasse 25, 1030 Vienna, Austria.
authors: K
authors: K
authors: Rappersberger
mesh_terms: D000280:Administration, Inhalation; D018450:Disease Progression; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage* / Q000009:adverse effects; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D007376:Interleukin-2; D011994:Recombinant Proteins