Potential of Interferon-α in Solid Tumours
- Sundar SanthanamAffiliated withDepartment of Oncology, Leicester Royal Infirmary, Infirmary Square Email author
- , Marios DecatrisAffiliated withDepartment of Oncology, Leicester Royal Infirmary, Infirmary Square
- , Ken O’ByrneAffiliated withDepartment of Oncology, Leicester Royal Infirmary, Infirmary Square
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The second part of this review examines the use of recombinant interferon-α (rIFNα) in the following solid tumours: superficial bladder cancer, Kaposi’s sarcoma, head and neck cancer, gastrointestinal cancers, lung cancer, mesothelioma and ovarian, breast and cervical malignancies.
In superficial bladder cancer, intravesical rIFNα has a promising role as second-line therapy in patients resistant or intolerant to intravesical bacille Calmette-Guérin (BCG). In HIV-associated Kaposi’s sarcoma, rIFNα is active as monotherapy and in combination with antiretroviral agents, especially in patients with CD4 counts >200/mm3, no prior opportunistic infections and nonvisceral disease. rIFNα has shown encouraging results when used in combination with retinoids in the chemoprevention of head and neck squamous cell cancers. It is effective in the chemoprevention of hepatocellular cancer in hepatitis C-seropositive patients. In neuroendocrine tumours, including carcinoid tumour, low-dosage (≤3MU) or intermediate-dosage (5 to 10MU) rIFNα is indicated as second-line treatment, either with octreotide or alone in patients resistant to somatostatin analogues. Intracavitary IFNα may be useful in malignant pleural effusions from mesothelioma. Similarly, intraperitoneal IFNα may have a role in the treatment of minimal residual disease in ovarian cancer. In breast cancer, the only possible role for IFNα appears to be intralesional administration for resistant disease. IFNα may have a role as a radiosensitising agent for the treatment of cervical cancer; however, this requires confirmation in randomised trials.
On the basis of current evidence, the routine use of rIFNα is not recommended in the therapy of head and neck squamous cell cancers, upper gastrointestinal tract, colorectal and lung cancers, or mesothelioma. Pegylated IFNα (peginterferon-α) is an exciting development that offers theoretical advantages of increased efficacy, reduced toxicity and improved compliance. Further data from randomised studies in solid tumours are needed where rIFNα has activity, such as neuroendocrine tumours, minimal residual disease in ovarian cancer, and cervical cancer. A better understanding of the biological mechanisms that determine response to rIFNα is needed. Studies of IFNα-stimulated gene expression, which are now feasible, should help to identify molecular predictors of response and allow us to target therapy more selectively to patients with solid tumours responsive to IFNα.
- Potential of Interferon-α in Solid Tumours
Volume 16, Issue 5 , pp 349-372
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