Preoperative Interleukin-2 May Improve Outcomes in Gastric Cancer

Preoperative Interleukin-2 May Improve Outcomes in Gastric Cancer

According to results recently published in the Journal of Surgical Oncology, treatment with interleukin-2 (IL-2) prior to surgery may improve outcomes in patients with gastric cancer.

The stomach is an organ that is located in the upper abdomen. It is part of the digestive system that passes semi-digested food and liquid to the small intestine. Gastric cancer refers to cancer that arises from the inner lining of the stomach. Standard treatment for gastric cancer includes surgery, chemotherapy and/or radiation therapy.

Radical surgery for gastric cancer, in which a large portion of the stomach, surrounding lymph nodes, and possible surrounding tissues is removed, often leaves the body with lowered levels of specific immune (white) blood cells. The lower levels of immune cells are speculated to be an issue with not providing adequate defenses against the cancer cells remaining in the body following surgery, resulting in possible metastasis (spread) of the cancer. Therefore, researchers have evaluated the administration of IL-2 prior to surgery. IL-2 is a substance that is naturally produced by the body and stimulates the production of immune cells. It is believed that administering IL-2 prior to surgery in gastric patients might help to sustain immune cell levels following surgery.

Recently, researchers from Italy and New York conducted a clinical trial to evaluate the effects of low-dose administration of IL-2 prior to surgery in patients undergoing radical surgery for gastric cancer. This study included 69 patients; 35 of whom were treated with preoperative IL-2, and 34 of whom were treated with surgery alone. The outcomes of patients were directly compared. At 14 days following surgery, 15% of patients treated with IL-2 had low levels of specific white blood cells (CD4 cells < 500 mm/c) (when compared to levels prior to surgery), compared to 65% of patients who did not receive IL-2. Differences in the levels of white blood cell levels continued, with a significant increase of levels remaining in the patients treated with IL-2, even at 50 days following surgery. Patients treated with IL-2 had much fewer postoperative complications (2 out of 34), compared to those treated with surgery alone (11 out of 35). Furthermore, at 26 months following surgery, average overall and cancer-free survivals were improved in the group treated with preoperative IL-2.

The researchers concluded that administration of IL-2 prior to surgery may improve outcomes for patients with gastric cancer undergoing radical surgery. Further trials are required to confirm these findings and bring them into possible standard practice. Patients who are to undergo radical surgery for gastric cancer may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating pre-operative IL-2 or other novel therapeutic approaches. Two sources of ongoing information regarding clinical trials include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com.

Reference: Romano F, Cesana G, Berselli M, et al. Biological, histological, and clinical impact of preoperative IL-2 administration in radically operable gastric cancer patients. Journal of Surgical Oncology. 2004;88:240-247.

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