Dermatologic changes associated with adoptive immunotherapy of cancer

One of the major areas of biomedical investigation has been the development of new methods to treat metastatic cancers. Since the early 1980s, Steven Rosenberg and his colleagues at the National Cancer Institute have been developing a new therapy using lymphocytes from patients with cancer. This treatment has been termed "adoptive immunotherapy" because it involves the infusion of lymphokine-activated killer (LAK) cells generated in vitro; interleukin-2 (IL-2) is also infused, which generates more LAK cells in vivo. Continued studies of this experimental treatment have demonstrated promising results in the mediation of regression of advanced cancers. However, this immunotherapy is extremely toxic, inducing a widespread capillary leak syndrome that affects virtually all organ systems, including the skin. Clinical and laboratory evaluation of the skin and other organ systems have shown new information concerning the mechanisms of action of this immunotherapy, along with mechanisms of toxicity. This information is being used to maximize the therapeutic effect (ie, tumor regression) while minimizing toxic reactions.