Interferon toegevoegd aan chemo en bestraling verlengt leven van geselecteerde patienten met alvleesklierkanker

22 mei 2018: lees ook dit artikel:

https://kanker-actueel.nl/immuuntherapie-met-pegylated-recombinant-human-interleukin-10-am0010-in-fase-iii-studie-bij-uitgezaaide-gevorderde-alvleesklierkanker-na-uitstekende-resultaten-uit-eerdere-studies-bij-solide-tumoren.html

11 maart 2011: Bron: Medscape en Society of Surgical Oncology (SSO) 64th Annual Cancer Symposium: Abstract 31. Presented March 4, 2011.

Wanneer interferon wordt toegevoegd aan chemo en bestraling kan dat het leven beduidend verlengen van alvleesklierkankerpatienten die succesvol zijn geopereerd en in een goede lichamelijke conditie verkeren. Dat blijkt uit een kleinschalige fase II studie met 29 patienten. De studie kon en mocht wegens de te verwachten grote toxiciteit niet gerandomiseerd worden uitgevoerd. Op zich geeft deze studie hoopgevende resultaten maar ook de bijwerkingen zijn niet mis en er is heel duidelijk geselecteerd op de lichameljike gesteldheid van de patienten. Ook door het ontbreken van een controlegroep lijkt deze studie te klein en niet helemaal objectief om als spectaculair te worden gezien. hoewel Medscape er wel een artikel over schrijft. Hier enkele citaten uit dit artikel dat in zijn geheel te lezen is als u hier op klikt.

In the single-center phase 2 study, toxicity, quality of life, and survival were determined in 29 patients with resected pancreatic head adenocarcinoma who received 1 of 3 protocols: interferon-alfa-2b (3 million units on Monday, Wednesday, and Friday), cisplatin (30 mg/m², 6 doses), and 5-fluorouracil (175 mg/m² per day).

All patients had T3 tumors, 22 (79%) had positive lymph nodes, and 4 (14%) had positive (R1) margins. In all, 24 patients (86%) completed therapy.

After 62 months, 19 patients had died and 20 had recurrences (6 local, 13 distant, and 1 combined).

The median duration of overall survival for treated patients was 42.3 months (95% confidence interval, 30.5 to 54.2 months); 86% completed therapy.

Adverse effects included leukopenia (15 patients [54%]), neutropenia (12 patients [43%]), and fatigue, anorexia, and stomatitis (8 patients each [29%]). No grade 4 toxicity occurred.

According to Dr. Katz, "although the study was limited by its small size and unrandomized design, the overall survival duration of 42 months was remarkable, and almost twice . . . that typically associated with standard chemotherapy and chemoradiation regimens."

Patients were treated with external-beam radiation (50.4 Gy) followed by 2 courses of systemic 5-fluorouracil. The protocol was modified after the eleventh patient to include a 1-week break in the middle of chemoradiation.

Eastern Cooperative Oncology Group Performance Status ranged from 0 (11 patients [39%]) to 1 (17 patients [61%]). Quality of life was assessed using validated instruments based on a point system evaluating how well the patient felt after treatment.

Researchers concluded that interferon-based chemoradiation is associated with favorable survival when administered to patients with good performance status in the adjuvant setting at experienced treatment centers.

According to Charles Scoggins, MD, MBA, associate professor of surgical oncology at the University of Louisville, Kentucky, who moderated the session, "these data show a vast improvement in overall survival for patients afflicted with pancreatic cancer. This single-center report mirrors [the results] shown by the [group from the] Virginia Mason [Medical Center, in Seattle, Washington], and adds further evidence that under tightly controlled circumstances, the addition of interferon to adjuvant chemoradiation can provide real benefit to the patient while managing the challenging and complex toxicity profile.

"Unfortunately, this toxicity profile proved too much for the randomized multicenter trial that was conducted by the American College of Surgeons Oncology Group, leading to early stoppage of the trial."

interferon, pancreaskanker, alvleesklierkanker