scholarly journals High-dose interleukin-2 (HD IL-2) for advanced melanoma: a single center experience from the University of Pittsburgh Cancer Institute

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Diwakar Davar ◽  
Fei Ding ◽  
Melissa Saul ◽  
Cindy Sander ◽  
Ahmad A. Tarhini ◽  
...  
Keyword(s):  
Interleukin 2 ◽  
Advanced Melanoma ◽  
High Dose ◽  
Single Center ◽  
University Of Pittsburgh ◽  
Single Center Experience ◽  
Pittsburgh Cancer Institute ◽  
The University

High-dose interleukin-2 (HD IL-2) in the treatment of advanced melanoma: The University of Pittsburgh experience.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9075-9075
Author(s):  
Diwakar Davar ◽  
Melissa Saul ◽  
Ahmad A. Tarhini ◽  
An Tran ◽  
Kerry Trent ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Interleukin 2 ◽  
Complete Response ◽  
Median Number ◽  
Cox Proportional Hazards ◽  
Advanced Melanoma ◽  
High Dose ◽  
Severe Toxicity ◽  
University Of Pittsburgh ◽  
Radiological Data

9075 Background: IL-2 is a T-cell growth factor tested in a variety of regimens for advanced melanoma (MEL) and renal cell carcinoma (RCC). High-dose IL-2 (600,000-720,000 IU/kg administered intravenously every 8 hours for up to 14 consecutive doses) was approved by FDA for advanced MEL and RCC in 1998 based upon the durability of responses observed. Early studies of HD IL-2 reported overall (OR) and complete response (CR) rates of 16% and 8% respectively. Severe toxicity limited use to specialized centers with standardized protocols, either intensive care (ICU) or oncology specialty settings. The U Pittsburgh has treated 1022 patients with IL-2 at any dosage and we here present outcomes of 550 MEL pts treated with HD IL-2 in an oncology specialty non-ICU setting. Methods: Clinical and radiological data were collected on all pts treated with IL-2 using the UPCI Cancer Registry and Medical Archival System (MARS). Pharmacy records were reviewed for dosing details. The influence of baseline characteristics on treatment outcomes was assessed using Cox proportional hazards analysis. Results: A total of 848 pts received HD IL-2, of which 298 pts had RCC while 550 had MEL. Detailed pharmacy dosing records were reviewed from 176 pts treated over the past 12 years (2000-2012) who received a total of 3738 cycles. Of 165 pts evaluable for response, OR was documented in 24 pts (14.8%) and CR in 5 pts (3.0%). Median overall survival (OS) was 10.0 mos for all patients and 21.5 mos for responders (CR+PR). Median number of doses per cycle was 7. Toxicity was consistent with prior reports. HD IL-2 required ICU transfers in 5% and 1 death was attributed to HD IL-2. Pts with higher baseline lactate dehydrogenase (LDH) had poorer OS (p < 0.05). Conclusions: In this large and uniformly treated series of recent patients treated with IL-2 OR/CR rates with HD IL-2 are 14.8% and 3.0% respectively. Higher LDH is associated with poorer outcome. Biomarkers of response are currently being evaluated in banked clinical specimens collected from patients under the SPORE in Skin Cancer (P50 CA121973).

Nineteen-year single-center experience in 76 patients with penile cancer treated with high-dose-rate brachytherapy

Brachytherapy ◽  
2019 ◽  
Vol 18 (4) ◽  
pp. 493-502 ◽  
Author(s):  
Sylwia Kellas-Ślęczka ◽  
Brygida Białas ◽  
Marek Fijałkowski ◽  
Piotr Wojcieszek ◽  
Marta Szlag ◽  
...  
Keyword(s):  
Dose Rate ◽  
Penile Cancer ◽  
High Dose Rate ◽  
High Dose ◽  
Single Center ◽  
High Dose Rate Brachytherapy ◽  
Single Center Experience

Randomized placebo-controlled clinical trial of high-dose interleukin-2 in combination with a soluble p75 tumor necrosis factor receptor immunoglobulin G chimera in patients with advanced melanoma and renal cell carcinoma.

1997 ◽  
Vol 15 (3) ◽  
pp. 1052-1062 ◽  
Author(s):  
J S Du Bois ◽  
E G Trehu ◽  
J W Mier ◽  
L Shapiro ◽  
M Epstein ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Tumor Necrosis Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Necrosis ◽  
Interleukin 2 ◽  
Advanced Melanoma ◽  
High Dose ◽  
Biologic Effects ◽  
Necrosis Factor

PURPOSE A randomized, double-blind, placebo-controlled trial was performed to compare the toxicity and biologic effects of treatment with high-dose intravenous (IV) bolus interleukin-2 (IL-2) plus the recombinant human soluble p75 tumor necrosis factor (TNF) receptor immunoglobulin G (IgG) chimera (rhuTNFR:Fc) with high-dose IL-2 alone in patients with advanced melanoma and renal cell carcinoma. PATIENTS AND METHODS Twenty patients with advanced melanoma or renal cell carcinoma were randomized to receive IL-2 (Chiron, Emeryville, CA) 600,000 IU/kg every 8 hours on days 1 to 5 and 15 to 19 (maximum, 28 doses) combined with placebo or the rhuTNFR:Fc fusion protein (Immunex, Seattle, WA) 10 mg/m2 on days 1 and 15 and 5 mg/m2 on days 3, 5, 17, and 19. The impact of rhuTNFR:Fc on IL-2 toxicity and biologic effects was evaluated. RESULTS No clinically significant difference in toxicity was observed in the two treatment arms. The adjusted median number of IL-2 doses administered during cycle 1 was 24.5 (range, seven to 28) and 21.5 (range, five to 27) for the placebo and rhuTNFR:Fc arms, respectively (P = .544). IL-2-induced TNF bioactivity, neutrophil chemotactic defect, and serum IL-6, IL-8, and IL-1 receptor antagonist (IL-1RA) induction were suppressed by rhuTNFR:Fc. Two of nine assessable patients (22%) on IL-2/placebo and three of 10 patients (30%) on IL-2/rhuTNFR:Fc responded. CONCLUSION Despite evidence of in vitro neutralization of TNF functional activity and partial inhibition of other secondary biologic effects of IL-2, rhuTNFR:Fc does not reduce the clinical toxicity associated with high-dose IL-2 therapy. These results suggest that the toxicity and antitumor effects of IL-2 treatment are independent of circulating TNF.

scholarly journals High-Dose Ipilimumab and High-Dose Interleukin-2 for Patients With Advanced Melanoma

2020 ◽  
Vol 9 ◽  
Author(s):  
Ann W. Silk ◽  
Howard L. Kaufman ◽  
Brendan Curti ◽  
Janice M. Mehnert ◽  
Kim Margolin ◽  
...  
Keyword(s):  
Interleukin 2 ◽  
Advanced Melanoma ◽  
High Dose

scholarly journals Three Phase II Cytokine Working Group Trials of gp100 (210M) Peptide Plus High-Dose Interleukin-2 in Patients With HLA-A2–Positive Advanced Melanoma

2008 ◽  
Vol 26 (14) ◽  
pp. 2292-2298 ◽  
Author(s):  
Jeffrey A. Sosman ◽  
Carole Carrillo ◽  
Walter J. Urba ◽  
Lawrence Flaherty ◽  
Michael B. Atkins ◽  
...  
Keyword(s):  
Phase Ii ◽  
Mononuclear Cells ◽  
Interleukin 2 ◽  
Advanced Melanoma ◽  
Phase Iii ◽  
Clinical Activity ◽  
High Dose ◽  
Phase Ii Trials ◽  
Cell Immunity ◽  
Three Phase

Purpose High-dose interleukin-2 (IL-2) induces responses in 15% to 20% of patients with advanced melanoma; 5% to 8% are durable complete responses (CRs). The HLA-A2–restricted, modified gp100 peptide (210M) induces T-cell immunity in vivo and has little antitumor activity but, combined with high-dose IL-2, reportedly has a 42% (13 of 31 patients) response rate (RR). We evaluated 210M with one of three different IL-2 schedules to determine whether a basis exists for a phase III trial. Patients and Methods In three separate phase II trials, patients with melanoma received 210M subcutaneously during weeks 1, 4, 7, and 10 and standard high-dose IL-2 during weeks 1 and 3 (trial 1), weeks 7 and 9 (trial 2), or weeks 1, 4, 7, and 10 (trial 3). Immune assays were performed on peripheral-blood mononuclear cells collected before and after treatment. Results From 1998 to 2003, 131 patients with HLA-A2–positive were enrolled. With 60-month median follow-up time, the overall RR for 121 assessable patients was 16.5% (95% CI, 10% to 26%); the RRs were 23.8% in trial 1 (42 patients), 12.5% in trial 2 (40 patients), and 12.8% in trial 3 (39 patients). There were 11 CRs (9%) and nine partial responses (7%), with 11 patients (9%) progression free at ≥ 30 months. Immune studies including assays of CD3-ζ expression and numbers of CD4+/CD25+/FoxP3+ regulatory T cells, CD15+/CD11b+/CD14– immature myeloid-derived cells, and CD8+gp100 tetramer-positive cells in the blood did not correlate with clinical benefit. Conclusion The results again demonstrate efficacy of high-dose IL-2 in advanced melanoma but did not demonstrate the promising clinical activity reported with vaccine and high-dose IL-2 in any of three phase II trials.

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