Randomized phase III trial of high-dose interleukin-2 versus subcutaneous interleukin-2 and interferon in patients with metastatic renal cell carcinoma

David F. McDermott, Meredith M. Regan, Joseph I. Clark, Lawrence E. Flaherty, Geoffery R. Weiss, Theodore F. Logan, John M. Kirkwood, Michael S. Gordon, Jeffrey A. Sosman, Marc S. Ernstoff, Christopher P.G. Tretter, Walter J. Urba, John W. Smith, Kim A. Margolin, James W. Mier, Jared A. Gollob, Janice P. Dutcher, Michael B. Atkins

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627 Scopus citations

Abstract

Purpose: The Cytokine Working Group conducted a randomized phase III trial to determine the value of outpatient interleukin-2 (IL-2) and interferon alfa-2b (IFN) relative to high-dose (HD) IL-2 in patients with metastatic renal cell carcinoma. Patients and Methods: Patients were stratified for bone and liver metastases, primary tumor in place, and Eastern Cooperative Oncology Group performance status 0 or 1 and then randomly assigned to receive either IL-2 (5 MIU/m2 subcutaneously every 8 hours for three doses on day 1, then daily 5 days/wk for 4 weeks) and IFN (5 MIU/m2 subcutaneously three times per week for 4 weeks) every 6 weeks or HD IL-2 (600,000 U/kg/dose intravenously every 8 hours on days 1 through 5 and 15 to 19 [maximum 28 doses]) every 12 weeks. Results: One hundred ninety-two patients were enrolled between April 1997 and July 2000. Toxicities were as anticipated for these regimens. The response rate was 23.2% (22 of 95 patients) for HD IL-2 versus 9.9% (nine of 91 patients) for IL-2/IFN (P = .018). Ten patients receiving HD IL-2 were progression-free at 3 years versus three patients receiving IL-2 and IFN (P = .082). The median response durations were 14 and 7 months (P = .14), and median survivals were 17.5 and 13 months (P = .24). For patients with bone or liver metastases (P = .001) or a primary tumor in place (P = .040), survival was superior with HD IL-2. Conclusion: This randomized phase III trial provides additional evidence that HD IL-2 should remain the preferred therapy for selected patients with metastatic renal cell carcinoma.

Original languageEnglish (US)
Pages (from-to)133-141
Number of pages9
JournalJournal of Clinical Oncology
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2005

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    McDermott, D. F., Regan, M. M., Clark, J. I., Flaherty, L. E., Weiss, G. R., Logan, T. F., Kirkwood, J. M., Gordon, M. S., Sosman, J. A., Ernstoff, M. S., Tretter, C. P. G., Urba, W. J., Smith, J. W., Margolin, K. A., Mier, J. W., Gollob, J. A., Dutcher, J. P., & Atkins, M. B. (2005). Randomized phase III trial of high-dose interleukin-2 versus subcutaneous interleukin-2 and interferon in patients with metastatic renal cell carcinoma. Journal of Clinical Oncology, 23(1), 133-141. https://doi.org/10.1200/JCO.2005.03.206