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Annals of Oncology 15:610-612, 2004
© 2004 European Society for Medical Oncology

Original Paper

Targeting pulmonary metastases of renal cell carcinoma by inhalation of interleukin-2

Received 31 October 2003; revised 3 December 2003; accepted 22 December 2003

Introduction:

Pulmonary metastases of renal cell carcinoma (RCC) are associated with poor prognosis. Inhalation therapy with interleukin-2 (IL-2) is thus an appealing method for palliation. This multicenter study summarizes the national experience of IL-2 inhalation in patients with lung metastases of RCC.

Patients and methods:

Forty patients (median, 66.5 years of age) with radiologically documented progressing pulmonary metastases were enrolled. All patients had to be able to comply with inhalation technique, and were not candidates for other treatment options. Twenty-eight patients were systemic treatment-naïve. The protocol included three daily inhalations of IL-2 to a total dose of 18 MU. Treatment had to be continued until one of the following occurred: progression; a complete response; a life threatening toxicity; or patient refusal. Response was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST) system.

Results:

The disease–control rate reached 57.5%, with a partial response rate of 2.5% and a disease stabilization rate of 55%. Median time to progression was 8.7 months. The main side-effects were cough and weakness.

Conclusions:

Inhalation of IL-2 for the treatment of pulmonary metastases in RCC is feasible, tolerable and beneficial in controlling progressive disease for considerable periods of time. The definition of response of biological therapy may need to be re-assessed and modified: stable disease should be regarded as a favorable response.

O. Merimsky1,*, E. Gez2, R. Weitzen3, H. Nehushtan4, R. Rubinov5, H. Hayat6, T. Peretz7, M. Ben-Shahar8, H. Biran9, R. Katsenelson9, V. Mermershtein10, D. Loven11, N. Karminsky12, A. Neumann13, D. Matcejevsky14 and M. Inbar15

1 Unit of Bone and Soft Tissue Oncology, Division of Oncology, Tel-Aviv Sourasky Medical Center, affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; 2 Institute of Oncology, Rambam Medical Center, Haifa, affiliated to Rappaport School of Medicine, Technion, Haifa; 3 Division of Oncology, The Sheba Medical Center, Tel-Hashomer, affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; 4 Sharet Institute of Oncology, Hadassah Medical Center, Ein-Karem, Jerusalem, affiliated to Hadassah School of Medicine, The Hebrew University, Jerusalem; 5 Oncology Clinic, Lin Center, Haifa, affiliated to Rappaport School of Medicine, Technion, Haifa; 6 Institute of Oncology, Wolfson Medical Center, Holon, affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; 7 Sharet Institute of Oncology, Hadassah Medical Center, Ein-Karem, Jerusalem, affiliated to Hadassah School of Medicine, The Hebrew University, Jerusalem; 8 Unit of Oncology, Nahariya Medical Center, Nahariya; 9 Kaplan Medical Center, Rehovot, affiliated to The Hebrew University, Jerusalem; 10 Institute of Oncology, Soroka Medical Center, affiliated to Ben-Gurion University, Beer-Sheba; 11 Unit of Oncology, Ha'Emek Medical Center, Afula, affiliated to Rappaport School of Medicine, Technion, Haifa; 12 Institute of Oncology, Wolfson Medical Center, Holon, affiliated to with Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; 13 Institute of Oncology, Rabin Medical Center-Beilinson Campus, affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; 14 Division of Oncology, Tel-Aviv Sourasky Medical Center, affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv; 15 Division of Oncology, Tel-Aviv Sourasky Medical Center, affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Key words: inhalation therapy, interleukin-2, pulmonary metastases, renal cell carcinoma, response criteria


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