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Mesothelioma
Treatment
Articles
and Abstracts
Intrapleural
administration of interleukin-2 for the
treatment of patients with malignant
pleural mesothelioma: a Phase II
study.
Cancer
1998 Nov 15;83(10):2099-104
Astoul
P, Picat-Joossen D, Viallat JR, Boutin
C
Department
of Pulmonology, Hopital de la Conception,
Marseille, France.
BACKGROUND:
The prognosis associated with malignant
pleural mesothelioma (MPM) is poor in
spite of surgery, radiotherapy,
photodynamic therapy, or chemotherapy.
Therefore, new therapeutic strategies,
including intrapleural immunotherapy, are
being investigated. Several clinical
studies have demonstrated objective
antitumoral responses to intrapleural
interleukin-2 (IL-2) administration in the
treatment of malignant pleurisy. The
maximum tolerated dose, 24 x 10(6)
IU/m2/day for 5 days, was determined in a
Phase I study. Based on these results, a
Phase II study was conducted, in which
intrapleural IL-2 (21 x 10(6) IU/m2/day
for 5 days) was given to patients with
MPM. METHODS: Patients with histologically
documented MPM were evaluated for response
36 days after treatment by computed
tomography scan and thoracoscopy with
biopsies. Toxicity was recorded and graded
according to World Health Organization
criteria. Survival was calculated from the
start of treatment to death according to
the Kaplan-Meier method, and the survival
of responders and nonresponders was
compared using the log rank test. RESULTS:
Twenty-two patients entered this study. Of
the 22 cases of MPM, 19 were epithelial, 2
were mixed, and 1 was fibrosarcomatous.
Three patients had Stage IA disease, 1 had
Stage IB, 16 had Stage II, 1 had Stage
III, and 1 had Stage IV (Butchart
classification). All patients received
their planned treatment. No dose reduction
or interruption occurred. There were 11
partial responses and 1 complete response.
Stable disease occurred in 3 patients and
disease progression in 7 patients. The
overall median survival time was 18
months; the median survival time of
responders differed significantly from
that of nonresponders (28 months vs. 8
months, P less than 0.01). The 24- and
36-month survival rates for responders
were 58% and 41%, respectively.
CONCLUSIONS: These results confirm that
intrapleural administration of IL-2 is
well tolerated and has antitumor activity
in patients with MPM. The authors
recommend a dose of 21 x 10(6) IU/m2/day
for 5 days. However, determination of the
schedule of IL-2 and its superiority to
conventional treatment in a Phase III
study has yet to be accomplished.
PMID:
9827714, UI: 99043416
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