Retrospective analysis of the safety and efficacy of interleukin-2 after prior VEGF-targeted therapy in patients with advanced renal cell carcinoma

Daniel C. Cho, Igor Puzanov, Meredith M. Regan, Talya Schwarzberg, Virginia Seery, Mee Young Lee, Vivian Liu, Rupal Bhatt, Henry Koon, James W. Mier, Jeffrey A. Sosman, Michael B. Atkins, David F. McDermott

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Agents targeting vascular endothelial growth factor (VEGF) signaling have been advocated as frontline therapy for advanced renal cancer. The role of interleukin 2 (IL-2) therapy after resistance to VEGF-targeted therapy remains unexplored. We conducted a retrospective analysis of the tolerability and efficacy of IL-2 therapy in patients who had previously received VEGF-targeted therapy. Twenty-three consecutive patients who received salvage IL-2 therapy were analyzed. Fifteen patients had received prior tyrosine kinase inhibitors (TKIs) (sorafenib or sunitinib), whereas 8 patients had received bevacizumab alone. Six of 23 patients did not receive week 2 of cycle 1 of treatment. All 6 of these patients had received prior TKIs. The incidence of severe cardiac toxicities, including 1 sudden cardiac death, in patients receiving prior TKI was 40% (95% confidence interval, 16.3-67.7%), significantly higher than what is expected from historical experience. Only 1 of 23 patients proceeded to receive a second cycle of IL-2. No patients achieved a partial or complete response to therapy. This retrospective analysis highlights unexpected and severe cardiac toxicities in patients receiving IL-2 after VEGF-targeted TKI therapy. The assumption that IL-2 therapy can be safely administered after TKI therapy may not be valid. Further examination of the safety of this sequential approach is necessary and more cautious patient selection seems warranted.

Original languageEnglish (US)
Pages (from-to)181-185
Number of pages5
JournalJournal of Immunotherapy
Volume32
Issue number2
DOIs
StatePublished - Feb 1 2009

Keywords

  • Interleukin-2
  • Renal cancer
  • Tyrosine kinase inhibitors
  • VEGF

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pharmacology
  • Cancer Research

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