The use of interferon alpha-2b as adjuvant (following surgery) treatment does not appear to improve outcomes for patients with renal cell (kidney) cancer that is confined to the kidney and/or one regional lymph node. In fact, this treatment strategy may actually produce harmful effects in this group of patients, according to a recent article published in the
Journal of Clinical Oncology.
The kidneys are a pair of bean shaped organs located on each side of the spine. The kidneys filter the blood and eliminate waste in the urine through a complex system of filtration tubules. All of the blood in the body passes through the kidneys approximately 20 times an hour. Renal cell cancer is an uncommon form of cancer that is most often characterized by the presence of cancer cells in the lining of the filtration tubules of the kidney. When renal cell cancer is greater than 7 cm but still confined to the kidney, it is referred to as stage II. When the cancer has spread locally outside the kidney and/or with spread to only one involved lymph node, it is referred to as stage III.
Interferon is a substance naturally produced in the body to help stimulate the immune system. Interferon alpha-2b is a compound produced in a laboratory that mimics the structure and action of interferon. The use of interferon has yielded promising results in some types of cancer, by stimulating the immune system to recognize and destroy cancer cells. However, interferon used alone as adjuvant treatment for renal cell cancer remains controversial, as side effects can be severe and no definitive conclusions regarding improved survival following treatment have been established.
Researchers from Italy recently conducted a clinical trial to evaluate the effectiveness of adjuvant interferon alpha-2b therapy in the treatment of renal cell cancer. The patients in this trial had either stage II or III renal cell cancer. All patients underwent surgery to remove their cancer, and then received either adjuvant interferon treatment or no further treatment (control group). Over half of the patients receiving adjuvant therapy developed signs of toxicity directly attributed to interferon alpha-2b, including flu-like symptoms, hematologic (blood) and liver associated complications. Approximately 5 years following treatment, cancer recurrences occurred in 51 of the 123 interferon treated patients and only 38 of the 124 in the control group. Thirty-seven patients in the treated group died from renal cell cancer, compared with 33 patients in the control group.
These results indicate that adjuvant treatment with interferon alpha-2b does not appear to provide benefit to patients whose cancer is confined to the kidney or involves only one regional lymph node. Researchers conducting this study report that this treatment actually may cause detrimental effects for these patients. Patients with renal cell cancer may wish to speak with their physicians about the risks and benefits of participating in a clinical trial evaluating promising new strategies.
Journal of Clinical Oncology, Vol 19, No 2, pp 425-431, 2001)