Inhalative Immuntherapie des pulmonal metastasierten Nierenzellkarzinoms

Interleukin-2 inhalation therapy prevents suffocation by pulmonary or mediastinal metastatic progress in most patients for considerable periods of time. It is well tolerated, performed on an outpatient basis, and allows employment or family care. It reliably induces a dose-dependant immunomodulation in the lung. Total cells, activation markers, IL-5 production, and nitric oxide increase. Major side effects are cough and fatigue. IL-2 aerosol administration leads to the longest progression-free survival times. A study from Israel reports a median time to progression of 8.7 months in 40 previously progressive patients not suitable for systemic therapy. For the first time, high-risk patients without treatment alternatives experience long-term survival. Survival was twice as long (12 vs 6.3 months) in a German study in the inhalation group (INH, n=94) compared to those systemically treated (SYST, n=103); 5-year-survival was 21 (INH) and 0% (SYST), respectively. In conclusion, aerosol interleukin-2 therapy is feasible, well tolerated, and beneficial in patients at risk of suffocating from metastatic renal cell carcinoma.