[Multidisciplinary treatment for liver metastasis using cytokines]

Abstract

The liver is an immunologic organ with liver-associated macrophages, so-called Kupffer cells, and natural killer-like primitive T cells. These cells may play an important role in resistance to liver metastasis. T cells are activated by the T cell growth factor, interleukin-2 (IL-2). Based on the theoretical rationale, a pilot study was conducted in 20 patients with liver metastases from primary colorectal cancer who underwent potentially curative liver resection, followed by adjuvant immunochemotherapy. The regimen consisted of a weekly hepatic arterial infusion of IL-2 1.4-2.1 x 10(6) units, and 5-fluorouracil 250 mg, and a bolus of mitomycin C 2-4 mg for 6 months. Of the 20 patients, 14 are still alive with a median postoperative survival of 69.7 months (September, 2000). The 5-year overall survival rate is 78%. Although recurrent cancer developed in 6 of the 20 patients, no patients had recurrence in the residual liver. We conclude that IL-2-based immunochemotherapy is useful in combination with liver resection for the prevention of liver recurrence in colorectal cancer patients with liver metastases. A multicenter, randomized trial is recommended.