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M Andres

Publications and source records attributed to M Andres.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Prognostic factors of the clinical response to subcutaneous immunotherapy with interleukin-2 alone in patients with metastatic renal cell carcinoma.

The intravenous immunotherapy with interleukin 2 (IL-2) represents one of the most active therapies of metastatic renal cell carcinoma (RCC). Recently, it has been demonstrated that IL-2 given subcutaneously in association with interferon alpha (IFN) may determine a response rate in RCC comparable to that obtained with an intravenous route of administration, but with a lower toxicity. Moreover, our previous data have suggested that IFN is not essential for IL-2 efficacy. On the basis of these data, we have designed a protocol of immunotherapy with IL-2 alone given subcutaneously in the treatment of metastatic RCC. The study included 48 consecutive evaluable patients. IL-2 was given at a daily dose of 6 million IU for 5 days/week for 6 consecutive weeks, corresponding to one IL-2 cycle. The overall response rate was 14/48 (29%; CR:1; PR:13). Response rate was significantly higher in nephrectomized than in nonnephrectomized patients, and in patients with a good compared to those with a low performance status. Patients with an interval between the diagnosis of primary renal tumor and of its metastases longer than 1 year did better than those with a lower interval, as did patients with a single metastasis compared to those with multiple metastases, while no significant difference was seen in relation to sex, age and previous IFN therapy. As far as dominant metastasis sites are concerned, patients with liver metastases showed a response rate significantly lower than that seen in patients with metastases in sites other than liver. Toxicity was low in all patients. This study shows that the subcutaneous immunotherapy with IL-2 alone is a well tolerated and effective therapy of metastatic RCC. The evidence of a low PS, disseminated tumor and liver metastases represents the most important negative prognostic factor for the response to therapy.

Adult↗
PubMedDate not supplied

Second-line therapy with interferon-alpha plus vinblastine in metastatic renal cell cancer patients progressed under interleukin-2 subcutaneous immunotherapy.

AIMS AND BACKGROUND: Interferon (IFN) +/- vinblastine (VNB) has appeared to be effective as first-line therapy of metastatic renal cell cancer. This study was performed to establish the efficacy of IFN plus VNB in metastatic RCC previously treated with interleukin-2 (IL-2). METHODS: The study included 14 metastatic renal cell cancer patients who did not respond to IL-2 subcutaneous therapy or who relapsed after initial response or stable disease. IFN-alpha 2a was given subcutaneously at 3 million U thrice a week in association with VNB (0.1 mg/kg i.v. every 21 days) until progression or toxicity. Patients were considered as evaluable when they were treated for at least 1 month. RESULTS: Evaluable patients were 13/14. No patient had a complete response. Partial response was achieved in 2/13 (15%) patients. Stable disease was seen in 5/13 patients, and the last 6 progressed. CONCLUSIONS: This study, by showing a tumor response rate comparable to that reported with first-line therapy, suggests that previous IL-2 immunotherapy does not influence negatively the efficacy of IFN+VNB in metastatic renal cell cancer.

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[Use of the Wiruthan prosthesis in uretero-cutaneostomy].

Ureterocutaneostomy (UCS) is a urinary diversion (UD) which is current little used, since, in addition to its very invalidating character, especially from a socio-psychological point of view, it is accompanied by complications such as ureteral stenosis, infections and parenchymal injury. Some of these complications may be partly related to the type of prosthesis used. From January 1987 prosthesis in Wiruthan polyurethane, an inert material with excellent biocompatibility features, were used in 20 patients who had to undergo UCS. The use of these long-lasting prosthesis was easy, well tolerated and enabled the patients to achieve a better quality of life. The prosthesis required moderate maintenance and reduced the complications which are often found in UCS. This positive experience prompts the Authors to recommend the use of these prosthesis in patients with UD.

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