Prospective, randomized trial to evaluate high-versus low-dose interferon-α2b versus conventional chemotherapy in prevention of the recurrence of superficial transitional cell carcinoma of the urinary bladder

Interferons, a group of naturally occurring proteins, possess potent immunological effects. The availability of large amounts of purified interferon through recombinant DNA technology has led to the testing of these agents against a number of tumor types. Interferon-α has been the most widely studied. The most encouraging results have been observed in the treatment of melanoma among nonhematological neoplasms, and in the locoregional treatment of other tumor types. It is hoped that further research into the use of the interferons, both singly and in combination with chemotherapy and other immunological agents, will lead to a better elucidation of their therapeutic role against cancer. In this article, the use of interferons in the treatment of solid tumors is reviewed.

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“…Encouraging results have been reported by a number of investigators [68][69][70]; once again, the higher dose of IFN seemed to be more effective.…”

Section: Bladder Cancermentioning

confidence: 63%

Interferons in the Therapy of Solid Tumors

Agarwala

Kirkwood

1994

Oncology

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“…The combination of interferons and cytotoxic agents has been proposed to give synergistic effects but the mechanisms behind such effects are not yet fully understood, nor is the optimal dosage of interferons established (5,18,23). Interferons seem to inhibit several enzymatic steps involved in cell replication and may thereby increase the sensitivity to cytotoxic drugs (8,19).…”

Section: Discussionmentioning

confidence: 99%

Effects of Intravesical Instillation of 5-Fluorouracil and Interferon in Patients with Recurrent Superficial Urinary Bladder Carcinoma: A Clinical and Pharmacodynamic Study

Hugosson¹,

Bergdahl²,

Carlsson³

et al. 1997

Scandinavian Journal of Urology and Nephrology

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Eleven patients with recurrent superficial bladder tumours were treated with 6 weekly instillations of 10 million IU Introna and 1000 mg 5-fluorouracil for 1 h. Before and immediately after the first treatment biopsies were taken from normal urothelium and tumour for analysis of thymidylate synthase (TS). One papillary tumour was left as a marker. Tumour tissue had 9 times higher TS concentrations than normal urothelium (0.97 versus 0.11 pmol/g, p < 0.005). Despite a large variation in TS concentration in the tumours between different patients (range 0.02-2.24 pmol/g), after instillation the TS concentration decreased significantly in all but one patient. Six patients had complete and 2 had partial tumour regression after treatment. The effect was inversely correlated to the initial TS value. A low TS value seemed to predict a good response. The data suggest that weekly administrations are not sufficient in those with high TS concentrations. New treatment schedules may be beneficial in those with highly proliferating bladder tumours.

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“…However, its many adverse effects, Le. bladder irritability, cystitis, fever and even deaths, have led to a search for other, less toxic forms of treatment [7]. Alpha2b-IFN has become a widely used and intensively researched form of immunotherapy for the treatment and prophylaxis of superficial bladder tumours since interferon was first described in 1957, and current findings suggest that.…”

Section: Discussionmentioning

confidence: 99%

“…The most common approach to treating superficial bladder cancer is transurethral resection (TUR) with fulguration of the tumour, but even with this treatment up to 85% of patients will have recurrent tumours, often during the first year [1][2][3]. Intravesical chemotherapy has therefore been investigated widely and used as a prophylactic against recurrences [4][5][6]: since 1976, immunotherapy has also offered substantial possibilities for treating superficial bladder cancer [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Epirubicin (4'-epi-doxorubicin) is reportedly effective for prophylactic treatment, with few side-effects [4,5,10] despite reports to the contrary [6,11]. Intravesical immunotherapy with alpha2b-interferon (alpha2b-IFN) has been shown to be of comparable efficacy to conventional chemotherapy, with a low incidence of systemic or local adverse effects [7]. Interferon has also been used succesfully in combination with chemotherapeutic drugs such as mitomycin C and epirubicin [8,12].…”

Section: Introductionmentioning

confidence: 99%

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