Intraperitoneal interferon in the management of malignant ascites

Abstract

Background. Ascites secondary to malignancy is a major cause of recurring morbidity in patients with ovarian cancer. In patients previously treated with cisplatin, other chemotherapeutic agents are not likely to be effective in relieving symptoms. Methods. A pilot group of ten patients was treated with intraperitoneal alpha‐2B‐interferon (α‐2B‐IFN) in an effort to provide symptomatic relief of their ascites. All patients had advanced epithelial ovarian cancer at the time of therapy and were receiving treatment for palliation only. Symptoms included abdominal distention (100% of patients), nausea and vomiting in the absence of mechanical intestinal obstruction (60%), and dyspepsia (40%). Results. At a dose of 10 M units/m2 given intraperitoneally every 2 weeks for one to four treatments, the toxicity was low, but the benefits were minimal. Five (50%) patients reported symptomatic improvement of 2–7 weeks' duration. The most common side effects included fever (temperature of more than 38.5°C) and abdominal pain. Conclusions. At the dose of 10 M units/m2 of intraperitoneal α‐2B‐IFN, this regimen did not appear to produce clinically significant palliation of the ascites in most patients.

Complete remission of ovarian cancer induced intractable malignant ascites with intraperitoneal bevacizumab. Immunological observations and a literature review

“…Diuretics have demonstrated to achieve high response rates in particular subsets of oncology patients, although their efficacy in women with peritoneal carcinomatosis has been questioned [4]. Intraperitoneal administration of Interferonalpha 2b has been attempted by a series of authors with complete response rates ranging from 10% to 30% [5][6][7]. This treatment requires frequent repeated administrations [7] and is associated with nausea, dyspepsia, abdominal distension and flu like symptoms.…”

Immunotherapy of malignant ascites with trifunctional antibodies

“…application, including radioisotopes, radio-labeled monoclonal antibodies 15,16 and biological response modifiers (e.g., IFN-a, IFN-b, IL-2, TNF-a). [17][18][19][20] In these studies a reduction of ascites accumulation was achieved in 30-80% of patients, which was generally of short duration. These reports collectively demonstrated that there was no clear guideline for palliative treatment of symptomatic ascites, indicating the essential need for a new effective treatment strategy.…”

Effective Relief of Malignant Ascites in Patients with Advanced Ovarian Cancer by a Trifunctional Anti-EpCAM × Anti-CD3 Antibody: A Phase I/II Study

“…Current therapies include diuretics, frequent large-volume paracentesis, i.p. or systemic chemotherapy, and a variety of other experimental strategies such as radiolabeled antibodies and immunostimulants (16,17). None of these approaches have been established as standard therapy for refractory malignant ascites because of limited efficacy or severe side effects (15,18).…”