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SERUM INTERLEUKIN-6 LEVELS IN METASTATIC RENAL CELL CARCINOMA BEFORE TREATMENT WITH INTERLEUKIN-2 CORRELATES WITH PARANEOPLASTIC SYNDROMES BUT NOT PATIENT SURVIVAL

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SERUM INTERLEUKIN-6 LEVELS IN METASTATIC RENAL CELL CARCINOMA BEFORE TREATMENT WITH INTERLEUKIN-2 CORRELATES WITH PARANEOPLASTIC SYNDROMES BUT NOT PATIENT SURVIVAL

Auteurs : Mcclellan M. Walther [États-Unis] ; Bruce Johnson [États-Unis] ; Donald Culley [États-Unis] ; Reena Shah [États-Unis] ; Jeff Weber [États-Unis] ; David Venzon [États-Unis] ; James C. Yang [États-Unis] ; W. Marston Linehan [États-Unis] ; Steven A. Rosenberg [États-Unis]

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RBID : ISTEX:3F215143C899A200E0723E984E09DB39E5CC88DD

Abstract

Purpose We sought to determine the frequency of interleukin-6 (IL-6) expression in renal cancer cell lines, the frequency of the detection of IL-6 in the serum of patients with metastatic renal cell carcinoma, whether serum IL-6 level correlates with the development of paraneoplastic syndromes and whether serum IL-6 level in patients with metastatic renal cancer correlates with response to treatment with interleukin-2 (IL-2) or patient survival.Materials and Methods Conditioned media from 21 cell lines from 20 patients were examined for IL-6. We identified 2 matched groups of patients with metastatic renal cancer (30 responders and 29 nonresponders) to IL-2 based immunotherapy. Stored pretreatment serum specimens were evaluated for IL-6. Medical records were reviewed to determine the presence of paraneoplastic syndromes.Results IL-6 was detected in 19 of 21 renal cancer cell lines (90) obtained from 20 patients with metastatic renal cancer as well as in the serum of 33 of 59 patients (56) with metastatic renal cell carcinoma. A significant association between serum IL-6 level and anemia (p = 0.0032), elevated platelet count (p = 0.01), decreased albumin (p = 0.034) and elevated alkaline phosphatase (p = 0.04) was found. A trend was noted of the association of increased serum IL-6 level and fever (p = 0.051). No correlation was found between pretreatment serum IL-6 level and survival or response to IL-2.Conclusions IL-6 was frequently secreted by renal cancer cell lines but it was only present in the serum of approximately half of the patients with metastatic renal cancer. Elevations of serum IL-6 were associated with paraneoplastic manifestations frequently seen in patients with renal cancer, including anemia, thrombocytosis, decreased albumin and elevations of alkaline phosphatase (Stauffer's syndrome). A weak relationship was noted between serum IL-6 level and fever but none was noted between that and survival or response to IL-2.

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DOI: 10.1016/S0022-5347(01)63709-1


Affiliations:


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<div type="abstract" xml:lang="en">Purpose We sought to determine the frequency of interleukin-6 (IL-6) expression in renal cancer cell lines, the frequency of the detection of IL-6 in the serum of patients with metastatic renal cell carcinoma, whether serum IL-6 level correlates with the development of paraneoplastic syndromes and whether serum IL-6 level in patients with metastatic renal cancer correlates with response to treatment with interleukin-2 (IL-2) or patient survival.Materials and Methods Conditioned media from 21 cell lines from 20 patients were examined for IL-6. We identified 2 matched groups of patients with metastatic renal cancer (30 responders and 29 nonresponders) to IL-2 based immunotherapy. Stored pretreatment serum specimens were evaluated for IL-6. Medical records were reviewed to determine the presence of paraneoplastic syndromes.Results IL-6 was detected in 19 of 21 renal cancer cell lines (90) obtained from 20 patients with metastatic renal cancer as well as in the serum of 33 of 59 patients (56) with metastatic renal cell carcinoma. A significant association between serum IL-6 level and anemia (p = 0.0032), elevated platelet count (p = 0.01), decreased albumin (p = 0.034) and elevated alkaline phosphatase (p = 0.04) was found. A trend was noted of the association of increased serum IL-6 level and fever (p = 0.051). No correlation was found between pretreatment serum IL-6 level and survival or response to IL-2.Conclusions IL-6 was frequently secreted by renal cancer cell lines but it was only present in the serum of approximately half of the patients with metastatic renal cancer. Elevations of serum IL-6 were associated with paraneoplastic manifestations frequently seen in patients with renal cancer, including anemia, thrombocytosis, decreased albumin and elevations of alkaline phosphatase (Stauffer's syndrome). A weak relationship was noted between serum IL-6 level and fever but none was noted between that and survival or response to IL-2.</div>
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