Efficacy of escalating doses of intravesical interferon α‐2b in reducing recurrence rate and progression in superficial transitional cell carcinoma

Abstract

Objective To compare the eBcacy of three diCerent doses groups A to D, respectively. The diCerences were statistically significant only between groups A and C of intravesical interferon a-2b P<0.001). The results were always in favour of the patients treated with the high dose, the only exception bimonthly for the next 4 months and thereafter monthly for 6 months. The patients were followed for being the diCerence between groups C and D (P= 0.026). No side-eCects of the drug were noted, nor 36 months. The four groups were compared for the number of recurrences (simple recurrence rate), prowas any adverse reaction reported from any patient. Conclusion These results show a significant advantage gression in stage, disease-free interval and recurrence rate per 100 patient-months.for adjuvant intravesical IFNa-2b treatment over TUR alone for the 36 months of follow up and indicate Results During the follow-up, 33 patients had recurrence (13, eight, seven and five in groups A to D, that IFNa-2b can modify the clinical course of superficial TCC at least in the short term. The appropriate respectively). The simple recurrence rate was 65% for group A, compared with 36% (P=0.06), 29% dose was apparently 80 MU, for although 40 MU was better than TUR alone, it was less eCective than 60 (P<0.05) and 22% (P<0.01) for groups B, C and D, respectively. The diCerences in simple recurrence rates MU and 80 MU; the 80 MU dose was slightly better than 60 MU and thus this regimen is recommended. between the groups treated with IFNa-2b were not statistically significant. Eleven patients experienced Keywords Interferon, transitional cell carcinoma, immunotherapy, progression, outcome progression in stage, with six, three, one and one in gression occurs in 5-30% of all cases and up to 80% of

IFN Alfa-2B and BCG Therapy is an Effective Method in Superficial Bladder Carcinoma

“…There was no difference in IL-10 levels between groups regardless of tumor grade and tumor stage in our study. Tumors with higher malignant potential produce higher levels of IFNα (10). In our study we observed that IL-2 and IL-6 levels were higher as the grade increased in both therapy groups regardless of stage.…”

“…They have anti-tumor effects through its nucleotide synthesis inhibiting, cytokine stimulating and anti-angiogenesis effects [8,9]. Although there is no consensus for the optimal dose, 50-100 million units are administered [10]. Flu-like symptoms may occur in 17% of cases.…”

Interferon-a2b Reduces Neo-Microvascular Density in the ‘Normal’ Urothelium Adjacent to the Tumor after Transurethral Resection of Superficial Bladder Carcinoma

“…Finally, systemic or subcutaneous IFN-a2b administration decreased angiogenesis and tumor growth of human bladder cancer cellline 253S B-V in an orthotopic athymic mouse model [28]. It has been shown that the schedule of IFN-a2b administration profoundly influences the therapeutic outcome [11]. Our study demonstrates that frequent IFN-a2b administration (weekly or twice a month), produced the maximal antiangiogenetic effect.…”

“…Group B (37 patients) received intravesicaly 50 millions IU of IFN-a2b (Intron ® A, Schering Plough, Kenilworth, New Jersey, USA), diluted in 50 ml normal saline. The instillations started within 7 days after TUR and were performed weekly for 2 months, twice a month for the next 4 months, and thereafter monthly for 6 more months [11]. Cold cup biopsies were taken before TUR of the TCC, from the tumor (T), near tumor (NT, 2 cm from the tumor where highly vascularized regions were cystoscopically observed) and from normal epithelium (N; under the view that TCC is a consequence of a 'field cancerization' phenomenon, 'normal' urothelium may be characterized by molecular alterations with a cystoscopically and microscopically normal phenotype).…”

Adjuvant Intravesical Mitoxantrone versus Recombinant Interferon-α after Transurethral Resection of Superficial Bladder Cancer: A Randomized Prospective Study

“…Mitoxantrone was instilled in the doses of 10 and 20 mg, which are usually used (no comparative study between them has been published). The dosage schedule of 100 MU of IFN·-2b was chosen according to studies showing that higher doses are more effective, while side effects are practically absent [11,12].…”