Phase II Trial of Subcutaneous Interleukin-2, Subcutaneous Interferon-α, Intravenous Combination Chemotherapy, and Oral Tamoxifen in the Treatment of Metastatic Melanoma: Final Results of Cancer Biotherapy Research Group 94-11
Abstract:This outpatient regimen was associated with significant toxicity including a 7% rate of possible treatment-related death. Tumor regression rates and survival were similar to results reported for chemotherapy alone, or inpatient IL-2-based therapy, but did not suggest an improvement in outcome.
“…In this study we examined tolerability, remission rates and outcome in patients with metastatic melanoma stage IV treated with a combination of temozolomide and IFN‐α2b, the latter in two different dosages. Our patient group showed a slight predominance of male patients, as is often found in series of patients with metastatic melanoma 4,24 , 25,33–35 . The mean age in our study was in the upper range (57·6 years) compared with many other studies, 4,5,12,13,24–26,33–37 ranging between 41 and 58·8 years.…”
Section: Discussionsupporting
confidence: 67%
“…In the literature, soft tissue metastases are most common, followed by lung, lymph node, brain and bone metastases 4,15 , 24,34 , 35,38 . The percentage of patients with liver metastases ranges between 20% and 39% 4,24 , 25,34 , 35,38 .…”
The combination of temozolomide and IFN-alpha 2b can easily be administered and shows tolerable toxicity. When an objective response occurs after three cycles, it indicates a significant survival advantage.
“…In this study we examined tolerability, remission rates and outcome in patients with metastatic melanoma stage IV treated with a combination of temozolomide and IFN‐α2b, the latter in two different dosages. Our patient group showed a slight predominance of male patients, as is often found in series of patients with metastatic melanoma 4,24 , 25,33–35 . The mean age in our study was in the upper range (57·6 years) compared with many other studies, 4,5,12,13,24–26,33–37 ranging between 41 and 58·8 years.…”
Section: Discussionsupporting
confidence: 67%
“…In the literature, soft tissue metastases are most common, followed by lung, lymph node, brain and bone metastases 4,15 , 24,34 , 35,38 . The percentage of patients with liver metastases ranges between 20% and 39% 4,24 , 25,34 , 35,38 .…”
The combination of temozolomide and IFN-alpha 2b can easily be administered and shows tolerable toxicity. When an objective response occurs after three cycles, it indicates a significant survival advantage.
“…However, the toxicities of high‐dose IL‐2 are rather intolerable, and intensive care is needed to manage its toxicity . Subcutaneous low‐dose IL‐2 for metastatic melanoma is tolerable and can be used in an outpatient setting . It can also be combined with cytotoxic agents or other cytokines such as interferon‐α.…”
Our data demonstrated that low-dose subcutaneous IL-2 plus DTIC has modest efficacy and may produce long-term survival in small proportion of patients. Furthermore, the treatment is well tolerated by patients.
“…Trials of chemotherapy and systemically delivered IL-2 in other tumors, however, have been generally disappointing [90–92]. This is perhaps not surprising in light of the preclinical studies discussed above and the well-established role of autocrine IL-2 signaling in CD8 T-cell function [93].…”
Section: Implementing Immunotherapy For Gbmmentioning
Recent advances in glioblastoma therapy have led to optimism that more effective therapies will improve outcomes. Immunotherapy is a promising approach that has demonstrated the potential to eradicate cancer cells with cellular-level accuracy while minimizing damage to surrounding healthy tissue. Several vaccination strategies have been evaluated for activity against glioblastoma in clinical trials. These include peptide vaccines, polyvalent dendritic cell vaccines, heat shock protein vaccines and adoptive immunotherapy. In this review, we highlight clinical trials representative of each of these approaches and discuss strategies for integrating these therapies into routine patient care.
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