Efficacy of Continuous Subcutaneous Infusion Therapy Using Interferon α and the Possible Prognostic Indicator of TNF‐α in Renal Cell Carcinoma

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Abstract
Background:In an attempt to improve efficacy by escalating the dose and maintaining higher serum concentrations over a long period of time, this study examines continuous interferon α (IFNα) subcutaneous infusion therapy in patients with renal cell carcinoma (RCC). Methods:Seven of 11 patients with RCC had evaluable metastatic lesions. A highly purified natural human IFNα was injected subcutaneously via an infuser pump for 5 consecutive days, followed by a 2‐day rest period (25 million IU/week). The treatment was continued for a period of 15 weeks. Serum concentrations of IFNα, IL‐1α, IL‐1β, TNF‐α, and IFNγ were measured at intervals throughout the study period. Results:Two of the 7 patients with evaluable lesions achieved a partial response (overall response rate, 29%), while 1 achieved a partial response only to lung metastasis. These 3 cases were defined as responders. No difference was found in the concentration of serum IFNα between responders and nonresponders, however, a significantly higher concentration of serum TNF‐a was observed in responders (PU test). Five cases (45%) had moderate to severe adverse effects, including depression (n = 1), eyeground hemorrhage (n = 2), and general fatigue (n = 2). Conclusion:Appropriate patient selection may be necessary for subcutaneous continuous infusion therapy for the treatment of metastatic RCC. Also, the serum concentration of TNF‐α measured during the course of treatment reflected well on the outcome of IFNα therapy.