Tumor Immunotherapy

The Tumor Immunotherapy Program at Columbia has the only comprehensive IL-2 Unit for the treatment of metastatic melanoma and kidney cancer in the New York City area.

Unique in the New York metropolitan region, this program draws upon collaborative efforts of laboratory and research staff to develop novel treatments using the body’s natural defenses to treat patients with cancer.

Tumor immunotherapy uses elements of the body’s immune system to fight cancer. Specific approaches include tumor vaccines, IL-2, and interferon, and combinations of these.

IL-2 is a therapy that attempts to harness the immune system to recognize that melanoma is foreign and attacks it. It is one of only a few drugs shown to have long term durable response or cure in melanoma.

How IL-2 Works

IL-2 is a type of natural protein, called a cytokine, produced by the body. It stimulates the white blood cells known as T-lymphocytes (T-cells) to grow and divide. T-cells are an important part of the body's immune system. Giving IL-2 in high doses stimulates the patient's immune system to better recognize and destroy cancer cells.

Interleukin-2 administered in high doses is the only FDA-approved therapy in the United States for the treatment of metastatic renal cell carcinoma and the first therapy approved for the treatment of metastatic melanoma in more than 20 years. Metastatic disease refers to cancers that have spread beyond the original site to additional tissue and organs.

Patients may receive IL-2 therapy alone or in combination with tumor vaccines. The Comprehensive IL-2 Unit of the Tumor Immunotherapy Program administers IL-2 through an intravenous (IV) line on an in-patient basis.

Benefits of IL-2 Therapy

High-dose IL-2 has resulted in disease regression in 15% to 20% of patients with advanced melanoma and advanced kidney cancer. About 6% to 8% of these patients experience lasting or complete regression of all disease.

Interferon

Interferon is a natural protein that stimulates the body’s response to fight infections and possible cancers. Interferon is also FDA-approved in treating melanoma. Interferon is administered either through an IV or an injection into the skin on an outpatient basis.

Scheduling/Dosing

Patients receive 2 cycles of IL-2 therapy given 2 to 3 weeks apart. Each cycle consists of about 5-7 days of in-hospital treatment. A CT (computed tomography) scan is taken 4 to 6 weeks after the completion of the first course (2 cycles). If the scan shows a response to the therapy, your physician may recommend that you come back for additional courses.

In general, you will receive as many doses of IL-2 as you can safely tolerate-up to a maximum of 15 doses over the period of your stay. Doses are given approximately every 8 hours and each dose takes around 15 minutes to administer.

A nurse will draw your blood every morning and the medical staff will evaluate your status throughout the day. During treatment other medications and fluids can be given through the PICC line.

IL-2 Side Effects

IL-2 therapy can cause a number of side effects including: low blood pressure, fevers, nausea, vomiting, diarrhea, infection, chills, swelling and weight gain, confusion, skin rashes, and changes in your liver and blood chemistries.

Fortunately, we can prevent and treat these side-effects as they arise. The day before you are admitted to the hospital, you will begin taking three medications to help prepare your body and reduce your chance of developing fevers, chills, and nausea.

During the course of your hospital stay you will receive antibiotics to prevent you from acquiring any infections. If you experience low blood pressure, we will administer fluids or medications to raise your pressure and make you feel more comfortable. Medications are also available to reduce skin rashes and prevent itching.

IL-2 Program for the Treatment of Melanoma or Renal Cell Carcinoma: Eligibility

Patients who are candidates for IL-2 treatment should meet the following criteria: 

  • Documented metastatic melanoma or renal cell carcinoma
  • Adequate performance (per Eastern Cooperative Oncology Group (ECOG) performance status.
  • Normal cardiac stress test (for patients > 50 years old)
  • Normal pulmonary function studies
  • Patients must not be using or have recently used steroids
  • Patients must not have active brain metastases.
  • Baseline CT scans and MRI of the brain within 4 weeks of starting therapy

If you would like further information please contact Dr. Bret Taback’s office at 212-305-9676. If you would like to refer a patient for consideration, please contact Dr. Taback.