High-dose interleukin-2 therapy for metastatic renal cell carcinoma: A contemporary experience

Michael Hanzly, Ahmed Aboumohamed, Naveen Yarlagadda, Terrance Creighton, Lorenzo Digiorgio, Ariel Fredrick, Gaurav Rao, Diana Mehedint, Saby George, Kristopher Attwood, Eric Kauffman, Deepika Narashima, Nikhil I. Khushalani, Roberto Pili, Thomas Schwaab

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To present our experience of high-dose interleukin-2 (HDIL-2) in a high-volume National Cancer Institute-designated center for patients with metastatic renal cell carcinoma (mRCC). Methods Patients with mRCC who received HDIL-2 monotherapy as a first- or second-line therapy during 2004-2011 were identified. Demographics, pathologic variables, renal function, time until the start of HDIL-2 therapy, number of cycles (1-3), responses (complete response, partial response, stable disease, and progressive disease), and primary renal cell carcinoma treatment were analyzed. Progression-free survival and overall survival (OS) were determined. Results Of 906 patients in the kidney cancer database, 91 patients with mRCC were treated with HDIL-2 and 18 patients (20.5%) underwent prior cytoreductive nephrectomy. Median age was 51 years, and 73.9% were men. Median follow-up was 45 months. Pretreatment renal function impairment led to more treatment cycles (2-3) than in those with adequate initial kidney function (92.3% vs 50.6%, respectively; P =.002). Lower tumor stage correlated with a better response (P =.023) and with longer time from diagnosis to initiation of HDIL-2 (P =.011). Complications included hypotension (67.4%), renal impairment (63%), impaired liver function (42.4%), and thrombocytopenia (31.5%). Four patients (4.5%) had a complete response, 10 (11.4%) had a partial response, and 28 (31.8%) had a stable disease. Median progression-free survival and OS were 8.6 and 35.5 months, respectively. The estimated 2-year OS rate was 60.6%. Conclusion Incorporating HDIL-2 therapy in the treatment strategies for mRCC added to the patients' survival in this series. HDIL-2 therapy is well tolerated in patients with pre-existing renal impairment with no long-term renal toxicity.

Original languageEnglish (US)
Pages (from-to)1129-1134
Number of pages6
JournalUrology
Volume83
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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