腎細胞癌に対するα型インターフェロンの治療成績

Abstract

腎細胞癌27例に, 組換え型ヒト白血球インターフェロンを投与し, 22例につき評価できた.評価転移巣は肺(74.1%), 骨(29.6%), 以下, 肝, 脳の順であった.1) Partial Response 3例, Minor Response (MR) 3例, No Change 7例, Progressive Disease 9例, 奏効率13.6%であった.2)副作用とし発熱, 食欲不振, 全身倦怠が, 臨床検査所見としGOT/GPTの上昇, 末梢白血球, 血小板の減少が主であった.3)インターフェロンに反応した例をMR, Mixed effect, Stabilization群に拡大し, 反応群(Responders, n=11)とし, 反応しなかったNon responders (n=11)と比べ, 臨床像の特徴を検討した.Respondersは, a) Performance Statusが良く, Disease-freeの期間が長い傾向にある.b)転移巣の数や大きさには関係なく, 肺単独か, 肺と肝以外の他の1臓器との組み合わせがよい.c)副作用とし血小板減少症の出現頻度が高い.4) 1984年8月31日現在, 4例は外来通院で, 4例は入院中でインターフェロンを投与し, 1例は投与中止し, 13例は死亡した.以上, 肺転移巣に比較的限った進行期腎癌に対し, インターフェロンは, 従来の治療法に比べ, かなりの効果が期待できる

Recombinant human leukocyte (alpha) interferon was administered i.m. at the initial dose of 3 X 10(6) U/day to 27 patients with measurable metastatic renal cell carcinoma during the past 2 years. The results of 22 of these patients were evaluable. Three patients (13.6%) showed partial response; 3 patients (13.6%), minor response; 7 patients (31.8%), no change; and 9 patients (40.9%), progressive disease. Major toxicity consisted of fever (55.5%), anorexia (44.4%), malaise (22.2%), elevation of GOT/GPT (48.1%), leukopenia (44.4%) and thrombocytopenia (29.6%). When the 3 patients who showed stabilization (S) and the 2 patients who showed mixed effects (ME) among the 7 patients who showed no change are classified into the responded group, half the patients had some response to interferon. Characteristics of these responders (PR + MR + ME + S) were good performance status, relatively longer disease-free interval, metastases limited to the lungs or metastasis to lungs and one other organ excluding the liver, and frequency of interferon-induced thrombocytopenia. Interferon administration is still being continued to 4 patients on an outpatient basis, 5 patients are hospitalized and 13 patients have died. In conclusion, patients with pulmonary metastases seem to be the best responding group for interferon treatment in renal cell carcinoma and further trials, especially combined regimens with chemotherapy and/or other kinds of interferon should be tested.