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Myositis associated with interleukin-2 therapy in a patient with metastatic renal cell carcinoma
F J Esteva-Lorenzo1, J E Janik, R G Fenton
1Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
Background:
Interleukin-2 (IL-2) has been used successfully in the treatment of some patients with metastatic renal cell carcinoma and melanoma, with a partial response rate of 15%-20%. It produces a well documented spectrum of side effects. Autoimmune diseases have been associated with IL-2 immunotherapy and the development of autoimmune thyroiditis may correlate with antitumor clinical response.
Methods:
A patient with metastatic renal cell carcinoma is described who developed a polymyositis-like myopathy after an autologous tumor vaccine and IL-2 therapy.
Results:
The patient had a delayed response for 15 months after developing this previously unreported toxicity.
Conclusions:
To the authors' knowledge, this represents the first reported case of necrotizing myositis in association with IL-2 therapy. Subsequent continuous partial response of the advanced malignancy was observed for 15 months. In this case, IL-2 may have broken tolerance to both normal muscle cells and tumor cells.