What is the efficacy of interleukin-2 (IL-2) in the treatment of renal cell carcinoma (RCC)?

Updated: May 21, 2019
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Answer

In the initial study by the National Cancer Institute (NCI), bolus intravenous (IV) infusions of high-dose IL-2 combined with lymphokine-activated killer (LAK) cells produced an objective response rate of 33%. In subsequent multicenter trials, not only was the response rate 16%, but LAK cells were shown to add no definite therapeutic benefit and could be eliminated from the treatment. [27] A high-dose regimen (600,000-720,000 IU/kg q8h for a maximum of 14 doses) resulted in a 19% response rate with 5% complete responses. The majority of responses to IL-2 were durable, with median response duration of 20 months; 80% of patients who had a complete response to IL-2 therapy were alive at 10 years.

Most patients had a clinical response after the first cycle, and those who did not show a response after the second cycle did not have a response to any further treatment. Therefore, the current recommendation is to continue treatment with high-dose IL-2 to the best response (up to 6 cycles) or until toxic effects become intolerable. Treatment should be discontinued after 2 cycles if the patient has had no regression. Combinations of IL-2 and interferon or other chemotherapeutic agents such as 5-fluorouracil (5-FU) have not been shown to be more effective than high-dose IL-2 alone.


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