Lymphokine-activated killer (LAK) therapy for metastatic renal cell carcinoma
Nakano, E.
Hinyokika Kiyo. Acta Urologica Japonica 38(11): 1305-1309
1992
ISSN/ISBN: 0018-1994 PMID: 1485586 Document Number: 396225
Fifteen patients with metastatic renal cell carcinoma (RCC) were treated by administration of autologous lymphokine-activated killer (LAK) cells given together with systemic administration of interleukin-2 (IL-2). Pulmonary metastases alone were found in 10 cases, pulmonary and mediastinal nodal metastases in 3, and pulmonary and bone metastases in 2. LAK cells, generated by incubation in 700 units/ml of IL-2 for 3 apprx 4 days, were intravenously administered once a week. In addition, beginning on the day of the first LAK cell infusion, 3.5 times 10-5 units of IL-2 were intravenously infused once or twice a day with occasional supplementation of 3.5 times 10-5 units of IL-2 on each day of LAK cell infusion. The total number of LAK cells and total amount of IL-2 administered per patient in this study ranged from 0.8 times 10-10 cells and from 10.2 times 10-6 to 74.9 times 10-6 units, respectively. As toxic effects caused by the infusion of LAK cells, headache, shaking chills, fever and leukocytosis were found in all cases. Side effects possibly induced by IL-2 infusion were tolerable fever, fluid retention (body weight gain of 2 apprx 3 kg) and eosinophilia. Out of 15 patients, a partial response was observed in 4 patients who had pulmonary metastases alone. One of the 4 patients with a partial response was clinically free of disease after undergoing a thoractotomy for resection of residual lesions, but a brain metastasis was detected 10 months after the thoracotomy. The remaining 3 patients are being closely followed up at present. In 3 of 11 patients who did not respond to this therapy, brain metastases were observed during or after the immunotherapy. In conclusion, although a complete respose could not be obtained, it can be said that this immunotherapy may be effective against RCC, particularly lung metastases, since a partial response was achieved in 4 of 15 patients. However, it should be taken into consideration that this immunotherapeutic approach may risk an increase in the frequency of brain metastases.