China
Africa
Explore chapters and articles related to this topic
Immunomodulatory Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Interferon alfa (IFN-α), found in the leukocyte fraction of human blood, is a mixture of several proteins, all with distinct functional, serological and structural characteristics. The major subtypes include IFN-α1, IFN-α2, IFN-α8, IFN-α10, IFN-α14, and IFN-α21, some of which (e.g., IFN-α2 and IFN-α14) are glycosylated. These proteins have potent but differential pharmacological activities. For example, IFN-α8 enhances the proliferation of human B cells and activates NK cells to some extent, whereas the α2, α8, and α10 subtypes are the most potent NK cell activators. Furthermore, subtypes α2 and α21 enhance the expression of IFN-gamma-inducible protein-10 (IP-10) in dendritic cells, stimulating them to initiate immune responses and induce the expression of chemokines (e.g., IP-10) which promotes inflammatory responses.
The Role of Interferons in the Therapy of Melanoma
Published in Ronald H. Goldfarb, Theresa L. Whiteside, Tumor Immunology and Cancer Therapy, 2020
Dosages from 12 Mu/M2 to 50 Mu/M2, as well as 50 Mu/M2 plus Cimetidine, gave comparable results at the Mayo Clinic with recombinant interferon alfa-2a in 96 patients with metastatic melanoma (45). A large experience has been reported with recombinant interferon alfa-2b given at 10 Mu/M2 administered subcutaneously three times a week, with overall response rates and durable complete response rates comparable to higher dose IV, and IM experiences (42). These are summarized in Table 1.
Specific Current Therapy for Myelomas
Published in Tariq I Mughal, John M Goldman, Sabena T Mughal, Understanding Leukemias, Lymphomas, and Myelomas, 2017
Tariq I Mughal, John M Goldman, Sabena T Mughal
Patients with myeloma respond well to radiotherapy. Local radiotherapy is used to relieve pain and for the treatment of patients who present with spinal cord compression. Total-body irradiation is often used as part of high dose chemotherapy preparative regimens for SCT. Interferon alfa has been shown to have anti-myeloma activity and increases the response rates achieved by chemotherapy. It has also been shown to be of modest value as maintenance therapy, once patients have entered a stable (plateau) phase. It is, however, associated with a number of mild but multiple side-effects (see section on “CML,” chap. 8), which often worsen the quality of life and make its use less acceptable.
Personalized approaches for treatment-naïve mantle cell lymphoma
Published in Expert Review of Hematology, 2023
Consolidation with high-dose chemotherapy followed by autologous stem cell rescue (HDT/ASCT) is an established approach in transplant-eligible patients with MCL. This is primarily based on results of the European-MCL phase III randomized clinical trial, which evaluated 269 patients with MCL in remission after CHOP-like chemotherapy [48]. Patients were randomized to ASCT or interferon alfa maintenance. Median PFS was 39 months in the ASCT group, as compared to 17 months in the interferon alfa group, and median OS was 7.5 years vs 4.8 years (HR = 0.66, 95% CI 0.46–0.95). Notably, the difference was especially prominent in those who received treatment without rituximab, whereas in those receiving rituximab-containing regimens there was no difference in PFS or OS. Additionally, CHOP-based chemotherapy was the most common regimen used, and maintenance rituximab was not routinely incorporated. These findings, along with findings from the TRIANGLE trial discussed above, raisequestions about the role of transplant in modern therapy [47].
Long-term Management of Panuveitis and Choroidal Mass Associated with Rosai Dorfman Disease with Pegylated Interferon
Published in Ocular Immunology and Inflammation, 2022
Lucas Kim, J. Clay Bavinger, Jessica G. Shantha, Anastasios Costarides, Hans E. Grossniklaus, Steven Yeh
Interferon alfa is a cytokine with antiviral, antitumor, and immunomodulatory activity, and there are a variety of interferon alfa medications approved to treat viral infections including hepatitis B and C and malignancies such as leukemia and melanoma.20 Interferon alfa-2b has also been used off-label to treat a number of ophthalmic disorders including uveitis after failing first-line therapies. These conditions include uveitis associated with Behcet’s disease,21 human herpesvirus 8,22 and demyelinating disease,23 idiopathic panuveitis, intermediate uveitis, serpiginous choroiditis, birdshot chorioretinopathy, Vogt-Koyanagi-Harada disease, sympathetic ophthalmia,24 pars planitis, and retinal vasculitis.25,26 Pegylated formulations of interferon, in which polyethylene glycol is linked to the interferon, have been developed to prolong the activity of therapy.
Safety of pembrolizumab for resected stage III melanoma
Published in Expert Opinion on Drug Safety, 2020
Overall, around 1500 patients with resected stage III melanoma have been treated with ipilimumab 10 mg/kg Q3W for 4 doses then every 12 weeks up to 4 additional doses in three phase III clinical trials to date: EORTC 18071, Checkmate-238 and E1609 comparing ipilimumab to placebo, nivolumab and high-dose interferon alfa-2b, respectively [14–16]. The overall incidence of treatment-related AEs was 90–98.8% with a rate of grade ≥3 AEs of 42.5–56.7%. The most frequently reported AEs were diarrhea/colitis (45.9–55.5%), fatigue/asthenia (41–44.6%), skin rash (29.4–58.6%) and alanine aminotransferase elevation (ALT, 14.6–32.4%). There was a total of 13 deaths related to ipilimumab (0–1.6%). Those AEs lead to discontinuation of ipilimumab in 42.6–54% of patients which is higher than has been observed in advanced melanoma [33]. In the phase III trial E1609, ipilimumab 3 mg/kg Q3W for 4 doses then every 12 weeks up to 4 additional doses has also been compared to high-dose interferon alfa-2b in 516 patients with a rate of grade ≥3 treatment-related AEs of 38.2% for an overall incidence of treatment-related AEs of 90% in the ipilimumab arm [15]. The most common AEs were diarrhea/colitis (50.6%), skin rash (46.7%) and ALT elevation (18.6%). There were 3 deaths related to ipilimumab (0.6%). The rate of discontinuation owing to AEs was 35%.