Intrapleural treatment with recombinant gamma‐interferon in early stage malignant pleural mesothelioma

Abstract

Background. This report presents the results of a prospective multi‐institutional study of intrapleural treatment with gamma‐interferon in patients with Butchart's Stages I and II epithelial or mixed malignant pleural mesothelioma. Methods. Interferon was administered at a dose of 40 million units twice a week for 8 weeks intrapleurally via a catheter or an implantable port. Thoracoscopic or surgical biopsy was performed if computed tomography scan 2 weeks after the end of treatment demonstrated a reduction in tumor size. Survival was calculated after a follow‐up of at least 18 months. Prognostic factors were identified by univariate and multivariate analyses (Cox model). Results. Eighty‐nine patients were included over 46 months. Eight histologically confirmed complete responses and nine partial responses with at least a 50% reduction in tumor size were obtained. The overall response rate was 20%. Most responses were achieved in patients with early stage disease. The response rate for patients with Stage I disease was 45%. Tolerance of interferon was good. Treatment was performed on an outpatient basis. The main side effects were hyperthermia, liver toxicity, neutropenia, and catheter‐related infection. Conclusions. Gamma‐interferon is effective mainly in Stage I mesothelioma, especially if the tumor is confined to the parietal or diaphragmatic pleura (Stage IA). Copyright © 1994 American Cancer Society