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P. LISSONI1,*, F. BRIVIO2, L. FUMAGALLI2,
G. DI FEDE3 and G. BRERA4
Abstract
The present study was carried out to evaluate the influence of a
short-period IL-2 administration on the efficacy of chemotherapy
in metastatic colorectal cancer patients with pretreatment
lymphocytopenia, which was defined as a lymphocyte count of less
than 1500/mm3.
The study included 144 consecutive metastatic colorectal
cancer patients, who underwent chemotherapy with oxaliplatin
plus 5-fluorouracil. Lymphocytopenia was seen in 41/144 (28%)
patients, who were randomized to receive chemotherapy alone or
chemotherapy after a prechemoimmunotherapy with IL-2 (3 MIU
twice/day for 3 consecutive days), whereas patients with a
normal pretreatment lymphocyte count received only chemotherapy.
A normalization of the lymphocyte number was achieved in
12/19 lymphocytopenic patients pretreated with IL-2. The
objective tumor regression rate achieved in patients with a
normal lymphocyte count prior to chemotherapy was significantly
higher compared to that obtained in lymphocytopenic patients
treated with chemotherapy alone (54/103 vs. 3/22, p<0.01),
whereas no significant difference occurred between patients with
normal lymphocyte count and lymphocytopenic patients pretreated
with IL-2 (54/103 vs. 8/19).
This study confirms that pretreatment lymphocytopenia is
associated with reduced efficacy of chemotherapy in metastatic
colorectal cancer patients. Moreover, it suggests that
pretreatment with IL-2 before the onset of chemotherapy may
enhance the efficacy of chemotherapy in lymphocytopenic patients.
Therefore, the administration of IL-2 before the onset of
chemotherapy to improve the immune status of cancer patients may
be considered as a new chemoimmunotherapeutic combination, which
may be recommended in the treatment of advanced cancer patients,
particularly in those with cancer-related immune alterations.
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