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A phase II trial of doxorubicin and interferon alpha 2b in advanced, non-medullary thyroid cancer

  • PHASE II STUDIES
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Summary

Background: The combination of doxorubicin and interferon alpha is supported by preclinical data. We sought to evaluate the efficacy of this combination in patients with advanced thyroid cancer. Patients and methods: Patients with locally recurrent or metastatic, radioiodine- refractory thyroid cancer, excluding medullary carcinoma, were treated with interferon alpha-2b 12 million units/m2 subcutaneously on days 1–5 and doxorubicin 40 mg/m2 intravenously, on day 3, every 28 days. Results: 17 patients, 15 with well differentiated and 2 with anaplastic thyroid carcinoma, were enrolled; median age was 69 years. Three patients had received radiation plus low dose doxorubicin previously. In 16 patients assessable for response, 1 patient (6%), who had follicular carcinoma, achieved a partial response and 10 patients (62.5%) stable disease as best response. Median time to progression was 5.9 months and median overall survival 26.4 months. In 14 evaluable patients, 5 (36%) had a thyroglobulin response (30% or more reduction in serum levels). Grade 3/4 neutropenia occurred in 76% of patients and neutropenic fever in 24%. Other grade 3/4 adverse events included fatigue (41%), rigors (18%), fever (6%), nausea/vomiting (29%), anorexia (29%), stomatitis (24%), vision disturbances (18%), neuropathy (18%), and hyponatremia (6%). One patient developed heart failure. Conclusions: Doxorubicin and interferon alpha was associated with considerable toxicities but modest antitumor activity in patients with advanced, non-medullary thyroid cancer.

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References

  1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57(1):43–66

    Article  PubMed  Google Scholar 

  2. Palme CE, Waseem Z, Raza SN, Eski S, Walfish P, Freeman JL (2004) Management and outcome of recurrent well-differentiated thyroid carcinoma. Arch Otolaryngol Head Neck Surg 130(7):819–824

    Article  PubMed  Google Scholar 

  3. Robbins J, Merino MJ, Boice JD, Jr., et al (1991) Thyroid cancer: a lethal endocrine neoplasm. Ann Intern Med 115(2):133–147

    PubMed  CAS  Google Scholar 

  4. McConahey WM, Hay ID, Woolner LB, van Heerden JA, Taylor WF (1986) Papillary thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. Mayo Clin Proc 61(12):978–996

    PubMed  CAS  Google Scholar 

  5. Holt E (2007) Controversies in the surveillance of patients with well differentiated thyroid cancer. Curr Opin Oncol 19(1):6–10

    Article  PubMed  Google Scholar 

  6. Samaan NA, Schultz PN, Haynie TP, Ordonez NG (1985) Pulmonary metastasis of differentiated thyroid carcinoma: treatment results in 101 patients. J Clin Endocrinol Metab 60(2):376–380

    Article  PubMed  CAS  Google Scholar 

  7. Kim JH, Leeper RD (1987) Treatment of locally advanced thyroid carcinoma with combination doxorubicin and radiation therapy. Cancer 60(10):2372–2375

    Article  PubMed  CAS  Google Scholar 

  8. Nilsson O, Lindeberg J, Zedenius J et al (1998) Anaplastic giant cell carcinoma of the thyroid gland: treatment and survival over a 25-year period. World J Surg 22(7):725–730

    Article  PubMed  CAS  Google Scholar 

  9. Cornett WR, Sharma AK, Day TA et al. (2007) Anaplastic thyroid carcinoma: an overview. Curr Oncol Rep 9(2):152–158

    Article  PubMed  Google Scholar 

  10. Shimaoka K, Schoenfeld DA, DeWys WD, Creech RH, DeConti R. A (1985) randomized trial of doxorubicin versus doxorubicin plus cisplatin in patients with advanced thyroid carcinoma. Cancer 56(9):2155–2160

    Article  PubMed  CAS  Google Scholar 

  11. Williams SD, Birch R, Einhorn LH (1986) Phase II evaluation of doxorubicin plus cisplatin in advanced thyroid cancer: a Southeastern Cancer Study Group Trial. Cancer Treat Rep 70(3):405–407

    PubMed  CAS  Google Scholar 

  12. Scherubl H, Raue F, Ziegler R (1990) Combination chemotherapy of advanced medullary and differentiated thyroid cancer. Phase II study. J Cancer Res Clin Oncol 116(1):21–23

    Article  PubMed  CAS  Google Scholar 

  13. Hoskin PJ, Harmer C (1987) Chemotherapy for thyroid cancer. Radiother Oncol 10(3):187–194

    Article  PubMed  CAS  Google Scholar 

  14. Liaw KY, Chang-Chien Y, Chen YC, Deng JS (1980) Impaired cell-mediated immunity function in thyroid cancer. Cancer 46(2):285–288

    Article  PubMed  CAS  Google Scholar 

  15. Lissoni P, Barni S, Tancini G et al (1995) Immunoendocrine therapy with low-dose subcutaneous interleukin-2 plus melatonin of locally advanced or metastatic endocrine tumors. Oncology 520(2):163–166

    Google Scholar 

  16. Moschos S, Varanasi S, Kirkwood JM (2005) Interferons in the treatment of solid tumors. Cancer Treat Res 126:207–241

    Article  PubMed  Google Scholar 

  17. Caraccio N, Giannini R, Cuccato S et al (2005) Type I interferons modulate the expression of thyroid peroxidase, sodium/iodide symporter, and thyroglobulin genes in primary human thyrocyte cultures. J Clin Endocrinol Metab 90(2):1156–1162

    Article  PubMed  CAS  Google Scholar 

  18. Lahat N, Sheinfeld M, Sobel E, Kinarty A, Kraiem Z (1992) Divergent effects of cytokines on human leukocyte antigen-DR antigen expression of neoplastic and non-neoplastic human thyroid cells. Cancer 69(7):1799–1807

    Article  PubMed  CAS  Google Scholar 

  19. Welander CE, Morgan TM, Homesley HD, Trotta PP, Spiegel RJ (1985) Combined recombinant human interferon alpha 2 and cytotoxic agents studied in a clonogenic assay. Int J Cancer 35(6):721–729

    Article  PubMed  CAS  Google Scholar 

  20. Wadler S, Schwartz EL (1990) Antineoplastic activity of the combination of interferon and cytotoxic agents against experimental and human malignancies: a review. Cancer Res 50(12):3473–3486

    PubMed  CAS  Google Scholar 

  21. Lupoli G, Cascone E, Arlotta F et al (1996) Treatment of advanced medullary thyroid carcinoma with a combination of recombinant interferon alpha-2b and octreotide. Cancer 78(5):1114–1118

    Article  PubMed  CAS  Google Scholar 

  22. Green MD, Speyer JL, Hochster HS et al (1988) Phase I trial of escalating dose doxorubicin administered concurrently with alpha 2-interferon. Cancer Res 48(9):2574–2578

    PubMed  CAS  Google Scholar 

  23. Sarosy GA, Brown TD, Von Hoff DD et al (1986) Phase I study of alpha 2-interferon plus doxorubicin in patients with solid tumors. Cancer Res 46(10):5368–5371

    PubMed  CAS  Google Scholar 

  24. Creagan ET, Frytak S, Long HJ, Kvols LK (1989) Phase I study of recombinant leukocyte A interferon (IFN-alpha 2A, Roferon-A) with doxorubicin in advanced malignant disease. Cancer 64(5):1034–1037

    Article  PubMed  CAS  Google Scholar 

  25. Pacini F, Lari R, Mazzeo S, Grasso L, Taddei D, Pinchera A (1985) Diagnostic value of a single serum thyroglobulin determination on and off thyroid suppressive therapy in the follow-up of patients with differentiated thyroid cancer. Clin Endocrinol (Oxf) 23(4):405–411

    CAS  Google Scholar 

  26. Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47(1):207–214

    Article  PubMed  CAS  Google Scholar 

  27. Siragusa M, Zerilli M, Iovino F et al (2007) MUC1 oncoprotein promotes refractoriness to chemotherapy in thyroid cancer cells. Cancer Res 67(11):5522–5530

    Article  PubMed  CAS  Google Scholar 

  28. Lu YS, Hsu C, Li CC et al (2004) Phase II study of combination doxorubicin, interferon-alpha, and high-dose tamoxifen treatment for advanced hepatocellular carcinoma. Hepatogastroenterology 51(57):815–819

    PubMed  CAS  Google Scholar 

  29. Upham JW, Musk AW, van Hazel G, Byrne M, Robinson BW (1993) Interferon alpha and doxorubicin in malignant mesothelioma: a phase II study. Aust N Z J Med 23(6):683–687

    PubMed  CAS  Google Scholar 

  30. Welander CE (1987) Overview of preclinical and clinical studies of interferon alfa-2b in combination with cytotoxic drugs. Invest New Drugs 5 (Suppl):S47–S59

    PubMed  CAS  Google Scholar 

  31. Cohen E, Vokes E, Rosen L et al (2007) A phase II study of axitinib (AG-013736 [AG]) in patients (pts) with advanced thyroid cancers. J Clin Oncol 25(18S):6008

    Google Scholar 

  32. Sherman SI, Schlumberger MJ, Droz J et al (2007) Initial results from a phase II trial of motesanib diphosphate (AMG 706) in patients with differentiated thyroid cancer (DTC). J Clin Oncol 25(18S):6017

    Google Scholar 

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Correspondence to Athanassios Argiris.

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Argiris, A., Agarwala, S.S., Karamouzis, M.V. et al. A phase II trial of doxorubicin and interferon alpha 2b in advanced, non-medullary thyroid cancer. Invest New Drugs 26, 183–188 (2008). https://doi.org/10.1007/s10637-007-9091-2

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  • DOI: https://doi.org/10.1007/s10637-007-9091-2

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