Study of intratumoral and intravenous administration of recombinant of human TNF in patients with advanced cancers

ABSTRACT

Twenty-eight patients with advanced cancers resistant to standard cytoreductive therapy were enrolled in this study [eight cases of lymphoma, four cases of melanoma, four cases of renal cell carcinoma, four cases of ovarian carcinoma, cases of pancreatic malignancies and four cases of breast cancer]. The study found that the mean TNF level in cancer patients = 57.09 +/- 11 pgm/ml [0.120 U/ml]. The study also found that the maximal plasma level of TNF is higher [60 U/ml] after intratumoral injection than after 24 hours infusion [5 U/ml]. The necrotizing effects of TNF on the tumor were observed in twelve patients after intratumoral administration and only in eight patients after continuous infusion. The side effects after 24 hours infusion were fever, chills, tachycardia, severe hypotension, nausea, vomiting diarrhea, fluid retention due to capillary leak syndrome, general prostration and CNS affection. These side effects after 24 hours infusion were more severe and took more time for resolution than after intratumoral injection in which the only side effects were fever, chill, tachycardia and change in blood pressure. So, it was concluded that intratumoral application of rHuTNF is better tolerated and more efficient than continuous 24 hours infusion