Thalidomide and IL-2 Effective for Metastatic Renal Cell Carcinoma

Thalidomide and IL-2 Effective for Metastatic Renal Cell Carcinoma

According to an article recently published in the journal Cancer, the treatment combination consisting of thalidomide (Thalomid®) and interleukin-2 (IL-2) provides disease control in over half of the patient with metastatic renal cell carcinoma.

The kidneys are a pair of bean-shaped organs located on each side of the spine that filter 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 carcinoma (RCC) is an uncommon form of cancer that is most often characterized by the presence of cancer cells in the lining of the kidneys filtration tubules. Cancer that has spread outside the kidney to several and/or distant sites in the body is referred to as metastatic RCC.

Il-2 is an agent that stimulates the immune system to fight cancer. Il-2 has been used to treat RCC for more than two decades.

The agent thalidomide is not yet approved for the treatment of cancer. It is classified as an immunodmodulatory (iMID) agent. Thalidomide prevents or reduces the production of blood vessels to cancer cells, ultimately starving the cancer from nutrients and oxygen and preventing their spread. Other biological activity of thalidomide is also thought to provide anticancer effects.

Researchers from the Methodist Hospital in Texas recently conducted a clinical trial to evaluate the combination of thalidomide plus IL-2 for the treatment of metastatic RCC. This trial included 52 patients who had not received prior therapy.

  • Complete disappearances of detectable cancer (complete remissions) occurred in 8% of patients.
  • Partial shrinkage of cancer occurred in 29% of patients.
  • Disease stabilization occurred in 15% of patients.
  • At the time of this publication, 27% were still alive, with the longest follow-up being over 45 months.
  • Twenty-three patients remain on therapy with thalidomide.
  • Side effects were mild to moderate.

The researchers concluded that the treatment combination consisting of thalidomide and IL-2 provides impressive anticancer activity for the treatment of metastatic RCC. Trials comparing this treatment regimen to other treatment approaches for RCC are warranted to establish optimal therapeutic strategies for these patients.

Patients with metastatic RCC may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating thalidomide/IL-2 or other promising treatment strategies. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Reference: Amato RJ, Morgan M, Rawat A. Phase I/II study of thalidomide in combination with interleukin-2 in patients with metastatic renal cell carcinoma. Cancer. 2006;106:1498-506.

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