Interleukin 2 therapy: current role in surgical oncological practice

Abstract

The use of recombinant interleukin 2 (rIL-2) in clinical practice has opened up new and beneficial avenues in the treatment of certain malignant diseases. Although rIL-2 can stimulate a range of host antitumour defence mechanisms, only 30-40 per cent of patients who are treated will respond to such therapy as assessed by a reduction in tumour volume. The effect of rIL-2-based treatment schedules on delaying progression of disease and on overall survival in comparison with standard current treatments and chemotherapeutic regimens is not clear. Randomized clinical trials are required to evaluate precisely the role of rIL-2 in various therapeutic combinations and to ascertain the optimum therapeutic regimens for individual tumour types. Studies currently under way should provide more insight into the possible beneficial effects of immunotherapy with rIL-2. More basic research is required to ascertain how rIL-2 may produce its antitumour effects and why the therapeutic results obtained in humans have been so selective and less beneficial than those in experimental animals.

Natural killer cells and cancer

“…The most beneficial results have been documented in patients with melanoma and renal cell carcinoma.226 Approximately 5% of patients with melanoma achieve a complete response rate and 25%, a partial response rate. 227 In patients with advanced renal cell carcinoma, overall response rates of 14% to 20% have been obtained following rIL-2 therapy,'282229 with a median duration of 357 days for partial and 926 days for complete responders. 215 However, much lower responses have been obtained in other solid tumors, e.g., colorectal ~ancer.2~' IL-2, in combination with cells with LAK activity, has been shown to result in the regression of lung, liver, and subdermal metastases of murine Infusion of autologous in vitro generated cells with LAK activity, in combination with rIL-2, has also been used to treat patients with disseminated cancer.…”

The psychological and psychiatric effects of rIL-2 therapy: a controlled clinical trial

“…It enhances various aspects of host defences, including natural cytotoxicity mediated by natural killer (NK) and lymphokineactivated killer (LAK) cells, which are believed to be important anti-cancer defence mechanisms. Recombinant IL-2 (rIL-2) has been used to modify tumour growth in experimental animal models and therapeutically in man (Heys et al, 1993.…”

Cyclosporin A Upmodulates the α-Subunit of the Interleukin-2 Receptor and the Metastatic Ability of Murine B16F10 Melanoma Cells

“…IL-2, either alone or in combination with lymphokine-activated killer cells, has been applied in the treatment of a range of human tumors [10,11]. However, the expression of the IL-2/IL-2R system has been reported in several tumor cells of nonhematopoietic origin [12][13][14][15][16][17].…”