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High dose interleukin-2 (Aldesleukin) - expert consensus on best management practices-2014

Dutcher, JP and Schwartzentruber, DJ and Kaufman, HL and Agarwala, SS and Tarhini, AA and Lowder, JN and Atkins, MB (2014) High dose interleukin-2 (Aldesleukin) - expert consensus on best management practices-2014. Journal for ImmunoTherapy of Cancer, 2 (1).

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Abstract

© 2014 Dutcher et al.; licensee BioMed Central Ltd. Interleukin-2 (IL-2) was historically one of the few treatments for adults with stage IV solid tumors that could produce complete responses (CRs) that were often durable for decades without further therapy. The majority of complete responders with metastatic renal cell carcinoma (mRCC) and metastatic melanoma (mM) could probably be classified as "cures". Recent publications have suggested improved efficacy, perhaps due to improved patient Selection based on a better understanding of clinical features predicting outcomes. Guidelines for clinical management were established from experience at the National Cancer Institute (NCI) and an affiliation of institutions known as the Cytokine Working Group (CWG), who were among the first to utilize HD IL-2 treatment outside of the NCI. As new centers have opened, further management variations have emerged based upon center-specific experience, to optimize administration of IL-2 and provide high quality care for patients at each individual site. Twenty years of evolution in differing environments has led to a plethora of clinical experience and effective management approaches. The goal of this review is to summarize the spectrum of HD IL-2 treatment approaches, describing various effective strategies that incorporate newer adjunctive treatments for managing the side effects of IL-2 in patients with mRCC and mM. The goal for IL-2 therapy is typically to administer the maximum number of doses of IL-2 without putting the patient at unacceptable risk for severe, irreversible toxicity. This review is based upon a consensus meeting and includes guidelines on pre-treatment screening, criteria for administration and withholding doses, and defines consensus criteria for safe administration and toxicity management. The somewhat heterogeneous best practices of 2014 will be compared and contrasted with the guidelines provided in 2001 and the package inserts from 1992 and 1998.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Dutcher, JP
Schwartzentruber, DJ
Kaufman, HL
Agarwala, SS
Tarhini, AAaat8@pitt.eduAAT8
Lowder, JN
Atkins, MB
Date: 16 September 2014
Date Type: Publication
Journal or Publication Title: Journal for ImmunoTherapy of Cancer
Volume: 2
Number: 1
DOI or Unique Handle: 10.1186/s40425-014-0026-0
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Article Type: Review
Date Deposited: 19 Sep 2016 17:31
Last Modified: 04 Feb 2019 16:55
URI: http://d-scholarship.pitt.edu/id/eprint/29492

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