[Joe]

Сообщение от Июля

Обращаюсь ко всем кто что либо может сообщить о лечении иммунотерапия конкретно Интерлейкин-2 (IL-2), который актуален но имеет большие побочные эффекты , кто то проходил такое лечение ? на форуме ни от кого не слышала везде только один (интерферон + авастин) , и по новому препарату ниволумаб (опдиво) кто то как то умудрялся получить его назначение и проходить лечение. Про таргеты на форуме много что написано а вот про это ничего не нашла. Подскажите кто что может!

У нас не популярно, хотя в США практикуют до сих пор (но только если у пациента хорошее самочувствие и если он сможет выдержать). Вот что пишут на умных пациентах:

High-dose Interleukin-2 is very intense therapy used to treat metastatic kidney cancer (usually the clear cell variant of RCC) or metastatic melanoma. It is not offered in most countries. The US and England have it available.

A patient is admitted to the hospital and has a PICC line inserted into the arm. In a dedicated ward or ICU, large doses of Interleukin-2 (bolus doses) are delivered every 8 hours while the patient is closely monitored. A total of 14 doses are planned over the next five days. Few patients receive all 14. Doses are missed due to blood pressure, fluid retention, and other problems. Patients can respond perfectly with fewer than half the scheduled doses. The higher number is the target so patients receive enough. The patient often does not remember much of this intense experience.

After the last dose for the week, the patient is observed until healthy enough to be released. The PICC line is removed and the patient spends a week out of hospital, scheduled to return on Monday of week 3 for another series of up to 14 doses.

After a break of two weeks or a bit longer, the patient is sufficiently recovered to do the whole thing over again.

Scans are usually done at the three-month mark to check the status of tumors. Response to IL-2 can be very delayed, so there may be no visible change. Steroids must be strictly avoided during IL-2 treatment and for at least 6 months following. Steroids destroy the immune response IL-2 creates.

At the first scan, there may be shrinkage. Some tumors may disappear, although often this takes longer to happen. Or - of course - there may be progression. Based on the scan and how the patient looks and feels, the decision is made to undergo another three-week cycle of treatment or stop. Rarely, a fourth cycle is performed.

About 8% of patients get complete and lasting response. Another 10 percent or so get a partial response (shrinkage of 30% or more overall). Stability is the result for another 20%, and sometimes the cancer does not grow after that.

The remaining 60% of patients receive no apparent benefit, although there are theories they may be more sensitive to various future treatments for their metastatic RCC.

Usually, high-dose IL-2 treatment has no long-term side effects.