Immunotherapy of metastatic kidney cancer.

From April 1986 to September 2000, 122 MRCC patients were treated by monthly intralymphatic injections (containing a mean of 573 IL-2 U and 26 x 10(6) LAK cells) and i.m. administration of IFN and TF; 71 patients also received a 3-day cycle of monthly IL-2 inhalations with a mean of 998 daily U. MRCC cases not treated by immunotherapy (n = 89) represent our historical controls. Adverse clinical side effects related to treatment were negligible. CR (n = 11) and PR (n = 13) were noticed in 24/122 patients. Of 24 responding patients, 17 resumed progression, whereas 7 remain in remission 11-69 months later. The overall median survival of treated patients (28 months) was 3.5-fold higher than the median survival of historical controls (7.5 months), and a Kaplan-Meier curve showed 25% survival 11 years after the beginning of immunotherapy. Apparently, the addition of IL-2 by inhalation improved survival. The present immunotherapy protocol appears to be efficacious, safe, devoid of adverse side effects, far less costly than others and able to offer a good quality of life to MRCC patients; if confirmed in a multicenter trial, it could set the basis for developing low-dose immunomodulatory treatments.

[Cardiac pacemaker and radiotherapy: a growing association. Report of a clinical case]. / Pacemaker cardiaco e terapia radiante: un'associazione in crescita. Descrizione di un caso clinico.

Cardiac pacing is increasingly common. In 1986, in the USA there were more than 500,000 pacemaker-implanted patients and at least 100,000 new pacemaker implants were performed, for a total of 3,000 pacemakers for million inhabitants. The increment in cardiac pacing is due to: a fall in cardiovascular mortality; increased elderly population, in which bradyarrhythmias are frequent; and the introduction of implantable cardioverter defibrillators (ICD). In 1992, in Italy, there were 30,500 deaths due to lung tumours and 10,900 deaths for breast malignancies. Both malignancies are more common in patients older than 65. Lung and breast cancer therapy involves the use of surgery, radiation, or chemotherapy, and often a combination of two or all three. In particular 40% of cancers are managed with radiotherapy. It is therefore likely that cancer patients may require radiotherapy at sites (lung, breast) where a pacemaker is implanted. The authors describe the finding on a chest radiogram of a one centimeter nodular mass at the right superior lobe almost completely hidden by the pacemaker. The modalities to proceed to radiotherapy, without damaging the sensitive pacemaker, are discussed.

Intra-lymphatic administration of interleukin-2 (IL-2) in cancer patients: a pilot study.

Seven patients suffering from advanced metastatic tumours, unresponsive to standard therapies, were treated with 3 to 5 intra-lymphatic injections of interleukin-2 (IL-2) and IL-2-activated-peripheral blood lymphocytes (PBL). A partial (50-70%) regression was obtained in three of the patients, and complete regression in the other four. It thus seems that intra-lymphatic injections of IL-2 and PBL can be used for the treatment of certain solid tumours (e.g., hypernephroma, adenocarcinoma, seminoma, epidermoid carcinoma) without noticeable side effects. This method could advantageously replace intravenous IL-2 administration and warrants further investigation.