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Interferon instillation for malignant pleural effusions

C A Goldman1, L F Skinnider, A W Maksymiuk

  • 1Durban Oncology Centre, Addington Hospital, Republic of South Africa.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|February 1, 1993
PubMed
Summary

Intrapleural interferon-alfa 2b (IFN-alpha 2b) showed a 70% response rate in malignant pleural effusions. This treatment was generally well-tolerated, suggesting potential for further clinical studies.

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Area of Science:

  • Oncology
  • Pulmonology
  • Immunology

Background:

  • Malignant pleural effusions are a common complication of various cancers.
  • Current management includes antineoplastic agents, but novel loco-regional therapies are being explored.
  • Interferon-alfa 2b (IFN-alpha 2b) has shown success in other malignancies, prompting investigation for pleural effusions.

Purpose of the Study:

  • To evaluate the tolerability and efficacy of intrapleural IFN-alpha 2b instillations for malignant pleural effusions.
  • To determine optimal dosing and assess treatment-related toxicities.

Main Methods:

  • Twenty-three patients with malignant pleural effusions received intrapleural IFN-alpha 2b (50 x 10(6) units).
  • Dose escalation to 75 x 10(6) units was used for persistent/recurrent effusions.

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  • Patients were monitored via clinical exams, imaging, labs, and lymphocyte assays.

    • Main Results:

    • A 70% response rate (14/20 evaluable patients) was observed, with a median response duration of 6 months.
    • Complete responses (CR) were achieved in 8 patients, and partial responses (PR) in 6.
    • Intrapleural IFN-alpha 2b was well-tolerated; the most common toxicity was a flu-like syndrome. Grade 3 neutropenia occurred at the escalated dose.

    Conclusions:

    • Intrapleural IFN-alpha 2b demonstrates an encouraging response rate for malignant pleural effusions.
    • The treatment is associated with acceptable toxicity, with no Grade 4 toxicities observed.
    • Further comparative clinical studies (Phase II/III) are warranted to validate these findings.