Interferon

Abstract

and Lindenmann1 has led to the establishment of a new field of research involving virology, immunology, tumor destruction, cell biology, and molecular genetics, as well as other disciplines. The bearers of interference (interferons) constitute a class of glycoproteins exhibiting antitumor, antiviral, and immu-See also p 1029. nologic properties. Three types of interferons are currently recognized: interferon alfa (alpha leukocyte interferon), interferon beta (fibroblast interferon), and interferon gamma (immune interferon). All three types of interferon have specific structures with interferon alfa and beta being most closely related. Multiple subtypes exist for interferon alfa and several for interferon beta.In this issue of the Archives, Edwards and coworkers2 demonstrate the antitumor effect of interferon alfa-2b in a sustained release formulation for the treatment of basal cell carcinomas. Two treatment regimens were utilized: a single injection of 10 million IU and a similar regimen (10 million IU) given once per week for 3 weeks. Both nodular and superficial basal cell carcinomas were included. Cure rates were 52% with those patients treated with one injection, and 80% for those patients receiving three injections. Two patients discontinued injections be¬ cause of side effects, with 82% of the patients experi¬ encing at least one severe adverse reaction.Interferon alfa has been shown to provide a safe and effective treatment for superficial and nodular basal cell carcinoma.3 Our initial study utilized a reg-imen of 1.5 million IU injected intralesionally three times a week for 3 weeks (nine total injections). All eight of the initial patients were completely cured with histologie excision of the treatment site found to exhibit no evidence of residual basal cell carcinoma.Minimal side effects were observed and were easily controlled with the administration of oral acetamin¬ ophen.Various studies have been conducted at our insti¬ tution and others in an effort to achieve the optimum dose. It was found that the administration of smaller doses over a shorter period of time resulted in decreased tumor response and cure rates. Increasing the dosage over shorter periods of time was also ac¬ companied by increased side effects. A large, multicenter trial for the evaluation of intralesional therapy of nodular and superficial basal cell carcinomas with the original treatment regimen of 1.5 million IU three times a week for 3 weeks is currently in press,4 with over an 80% cure rate achieved in this double-blind study with a 1-year histologie evaluation period.Other types of interferon appear to have much less effect than does interferon alfa in the treatment of basal cell carcinoma. Tank and coworkers4 and Ed¬ wards and coworkers6 both revealed a decreased an¬ titumor response in the intralesional treatment of basal cell carcinoma with interferon gamma, as com¬ pared with interferon alfa. Thus, it appears that the type of interferon appears to be significantly impor¬ tant in the treatment of basal cell carcinoma.The c...

Intralesional Interferon alpha-2b in the Treatment of Basal Cell Carcinoma and Squamous Cell Carcinoma: Revisited

“…At higher doses, depression can be observed. Transiently elevated liver enzymes that normalize within 2 to 5 days after therapy have also been observed at higher doses 14 . In addition, IFNα‐2b shows a dose‐related bone marrow suppression, which is reversible with discontinuation 27…”

“…Other authors have observed that some lesions with partial regression at 8 weeks after treatment progressed to achieve a histologic cure (without further treatment) at 16 weeks 12 . Many authors have noted that when a lesion appears to be clinically resolved, there is histologic resolution of the tumor as well 2,13–15 . It appears that a 16‐week posttreatment period is required for adequate assessment of IFNα‐2b efficacy.…”

Comparison of the Effects of Intralesional Interferon Alfa‐2a, 2b and the Combination of 2a and 2b in the Treatment of Basal Cell Carcinoma

“…Interferons inhibit cellular growth and modulate cellular function; therefore, they exhibit antineoplastic action (1). Many studies have shown that interferons are effective treatment for BCC; IFN-a appears to have much more effect than does IFN beta or gamma (2). Their mechanism of action is unknown.…”