High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: Analysis of 270 patients treated between 1985 and 1993

Michael B. Atkins, Michael T. Lotze, Janice P. Dutcher, Richard I. Fisher, Geoffrey Weiss, Kim Margolin, Jeff Abrams, Mario Sznol, David Parkinson, Michael Hawkins, Carolyn Paradise, Lori Kunkel, Steven A. Rosenberg

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the short- and long-term efficacy and toxicity of the high-dose intravenous bolus interleukin 2 (IL-2) regimen in patients with metastatic melanoma. Patients and Methods: Two hundred seventy assessable patients were entered onto eight clinical trials conducted between 1985 and 1993. IL-2 (Proleukin [aldesleukin]; Chiron Corp, Emeryville, CA) 600,000 or 720,000 IU/kg was administered by 15-minute intravenous infusion every 8 hours for up to 14 consecutive doses over 5 days as clinically tolerated with maximum support, including pressors. A second identical treatment cycle was scheduled after 6 to 9 days of rest, and courses could be repeated every 6 to 12 weeks in stable or responding patients. Data were analyzed through fall 1996. Results: The overall objective response rate was 16% (95% confidence interval, 12% to 21%); there were 17 complete responses (CRs) (6%) and 26 partial responses (PRs) (10%). Responses occurred with all sites of disease and in patients with large tumor burdens. The median response duration for patients who achieved a CR has not been reached and was 5.9 months for those who achieved a PR. Twelve (28%) of the responding patients, including 10 (59%) of the patients who achieved a CR, remain progression-free. Disease did not progress in any patient responding for more than 30 months. Baseline performance status and whether patients had received prior systemic therapy were the only predictive prognostic factors for response to IL-2 therapy. Toxicities, although severe, generally reversed rapidly after therapy was completed. Six patients (2%) died from adverse events, all related to sepsis. Conclusion: High-dose IL-2 treatment seems to benefit some patients with metastatic melanoma by producing durable CRs or PRs and should be considered for appropriately selected melanoma patients.

Original languageEnglish (US)
Pages (from-to)2105-2116
Number of pages12
JournalJournal of Clinical Oncology
Volume17
Issue number7
StatePublished - Jul 1999
Externally publishedYes

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Interleukin-2
Melanoma
Therapeutics
Tumor Burden
Intravenous Infusions
Sepsis
Clinical Trials
Confidence Intervals

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Atkins, M. B., Lotze, M. T., Dutcher, J. P., Fisher, R. I., Weiss, G., Margolin, K., ... Rosenberg, S. A. (1999). High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: Analysis of 270 patients treated between 1985 and 1993. Journal of Clinical Oncology, 17(7), 2105-2116.

High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma : Analysis of 270 patients treated between 1985 and 1993. / Atkins, Michael B.; Lotze, Michael T.; Dutcher, Janice P.; Fisher, Richard I.; Weiss, Geoffrey; Margolin, Kim; Abrams, Jeff; Sznol, Mario; Parkinson, David; Hawkins, Michael; Paradise, Carolyn; Kunkel, Lori; Rosenberg, Steven A.

In: Journal of Clinical Oncology, Vol. 17, No. 7, 07.1999, p. 2105-2116.

Research output: Contribution to journalArticle

Atkins, MB, Lotze, MT, Dutcher, JP, Fisher, RI, Weiss, G, Margolin, K, Abrams, J, Sznol, M, Parkinson, D, Hawkins, M, Paradise, C, Kunkel, L & Rosenberg, SA 1999, 'High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: Analysis of 270 patients treated between 1985 and 1993', Journal of Clinical Oncology, vol. 17, no. 7, pp. 2105-2116.
Atkins, Michael B. ; Lotze, Michael T. ; Dutcher, Janice P. ; Fisher, Richard I. ; Weiss, Geoffrey ; Margolin, Kim ; Abrams, Jeff ; Sznol, Mario ; Parkinson, David ; Hawkins, Michael ; Paradise, Carolyn ; Kunkel, Lori ; Rosenberg, Steven A. / High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma : Analysis of 270 patients treated between 1985 and 1993. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 7. pp. 2105-2116.
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abstract = "Purpose: To determine the short- and long-term efficacy and toxicity of the high-dose intravenous bolus interleukin 2 (IL-2) regimen in patients with metastatic melanoma. Patients and Methods: Two hundred seventy assessable patients were entered onto eight clinical trials conducted between 1985 and 1993. IL-2 (Proleukin [aldesleukin]; Chiron Corp, Emeryville, CA) 600,000 or 720,000 IU/kg was administered by 15-minute intravenous infusion every 8 hours for up to 14 consecutive doses over 5 days as clinically tolerated with maximum support, including pressors. A second identical treatment cycle was scheduled after 6 to 9 days of rest, and courses could be repeated every 6 to 12 weeks in stable or responding patients. Data were analyzed through fall 1996. Results: The overall objective response rate was 16{\%} (95{\%} confidence interval, 12{\%} to 21{\%}); there were 17 complete responses (CRs) (6{\%}) and 26 partial responses (PRs) (10{\%}). Responses occurred with all sites of disease and in patients with large tumor burdens. The median response duration for patients who achieved a CR has not been reached and was 5.9 months for those who achieved a PR. Twelve (28{\%}) of the responding patients, including 10 (59{\%}) of the patients who achieved a CR, remain progression-free. Disease did not progress in any patient responding for more than 30 months. Baseline performance status and whether patients had received prior systemic therapy were the only predictive prognostic factors for response to IL-2 therapy. Toxicities, although severe, generally reversed rapidly after therapy was completed. Six patients (2{\%}) died from adverse events, all related to sepsis. Conclusion: High-dose IL-2 treatment seems to benefit some patients with metastatic melanoma by producing durable CRs or PRs and should be considered for appropriately selected melanoma patients.",
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AU - Atkins, Michael B.

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AU - Fisher, Richard I.

AU - Weiss, Geoffrey

AU - Margolin, Kim

AU - Abrams, Jeff

AU - Sznol, Mario

AU - Parkinson, David

AU - Hawkins, Michael

AU - Paradise, Carolyn

AU - Kunkel, Lori

AU - Rosenberg, Steven A.

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N2 - Purpose: To determine the short- and long-term efficacy and toxicity of the high-dose intravenous bolus interleukin 2 (IL-2) regimen in patients with metastatic melanoma. Patients and Methods: Two hundred seventy assessable patients were entered onto eight clinical trials conducted between 1985 and 1993. IL-2 (Proleukin [aldesleukin]; Chiron Corp, Emeryville, CA) 600,000 or 720,000 IU/kg was administered by 15-minute intravenous infusion every 8 hours for up to 14 consecutive doses over 5 days as clinically tolerated with maximum support, including pressors. A second identical treatment cycle was scheduled after 6 to 9 days of rest, and courses could be repeated every 6 to 12 weeks in stable or responding patients. Data were analyzed through fall 1996. Results: The overall objective response rate was 16% (95% confidence interval, 12% to 21%); there were 17 complete responses (CRs) (6%) and 26 partial responses (PRs) (10%). Responses occurred with all sites of disease and in patients with large tumor burdens. The median response duration for patients who achieved a CR has not been reached and was 5.9 months for those who achieved a PR. Twelve (28%) of the responding patients, including 10 (59%) of the patients who achieved a CR, remain progression-free. Disease did not progress in any patient responding for more than 30 months. Baseline performance status and whether patients had received prior systemic therapy were the only predictive prognostic factors for response to IL-2 therapy. Toxicities, although severe, generally reversed rapidly after therapy was completed. Six patients (2%) died from adverse events, all related to sepsis. Conclusion: High-dose IL-2 treatment seems to benefit some patients with metastatic melanoma by producing durable CRs or PRs and should be considered for appropriately selected melanoma patients.

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