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

Area of Science:

• Oncology
• Immunotherapy

Background:

• High-dose Interleukin-2 (HD IL-2) has historically provided durable complete responses in advanced solid tumors.
• Metastatic renal cell carcinoma (mRCC) and metastatic melanoma (mM) patients achieving complete response with HD IL-2 may be considered cured.
• Improved patient selection based on clinical features may enhance HD IL-2 efficacy.

Purpose of the Study:

• To review the spectrum of HD IL-2 treatment approaches for mRCC and mM.
• To summarize effective strategies, including adjunctive treatments for managing side effects.
• To provide updated guidelines for safe HD IL-2 administration and toxicity management.

Main Methods:

• Consensus meeting to establish guidelines.
• Review of clinical management experience from the National Cancer Institute (NCI) and Cytokine Working Group (CWG).
• Comparison of 2014 practices with 2001 guidelines and 1992/1998 package inserts.

Main Results:

• Evolution of HD IL-2 management over 20 years has led to diverse, effective approaches.
• Identification of strategies to optimize IL-2 administration and patient care.
• Establishment of consensus criteria for pre-treatment screening, dose administration, and toxicity management.

Conclusions:

• HD IL-2 remains a potent treatment for mRCC and mM, with evolving management strategies.
• Optimizing HD IL-2 administration requires balancing efficacy with patient safety and toxicity management.
• Updated guidelines are crucial for consistent and high-quality care across treatment centers.