Aldesleukin

Definition

Aldesleukin is interleukin, or specific kind of biological response modifier, that is used to treat metastatic renal cell carcinoma (a form of kidney cancer) and metastatic melanoma. Aldesleukin is also known as interleukin-2, IL-2 and the trademarked name Proleukin.

Purpose

When renal cell carcinoma and metastatic melanoma (cancer of the skin that arises in the pigmented cells of the skin or eyes) do not respond to other therapies, they are candidates for treatment with aldesleukin.

Description

Aldesleukin is a biological response modifier (BMR). It promotes the development of T cells, or the cells in the lymphatic system that can fight cancer cells in cell-to-cell interaction. The human body produces aldesleukin naturally.

For use in therapy, aldesleukin is manufactured in a laboratory setting, using biotechnology methods, or methods that combine biological mechanisms and tools from technology. In the instance of aldesleukin, the compound is made in large quantities by using recombinant DNA technology. The DNA, or hereditary material, that provides instructions for making aldesleukin, is put in bacterial cells under laboratory confinement. The cells then produce large quantities of the human compound that are harvested, purified, and used for treatment.

Treatment with aldesleukin is considered palliative, which means it provides comfort but does not produce a cure. In some cases, aldesleukin is used together with an anticancer drug.

Recommended dosage

Standard treatment with aldesleukin is via an intravenous line. The standard dose is 0.037 milligrams per kilogram of body weight every eight hours. For renal cancer, up to 15 doses can be repeated over 7-10 days every 5-6 weeks. But because the aldesleukin has such severe side effects, lower doses are being tried. And delivery of aldesleukin via an inhaler, or a mechanical device that puts the compound into the air passages when a person breathes, is being used in the case of metastatic melanoma that has invaded the lungs.

Precautions

Side effects from aldesleukin are generally very severe. No one who already has a metastatic growth in the central nervous system should take the treatment because aldesleukin will incite, or aggravate, symptoms from the tumor.

Side effects

Aldesleukin causes changes in the ways body fluids accumulate in the body that can lead to ascites and pleural effusions. Changes in personality are common due to the influence the drug has on the central nervous system. Among the most severe side effects is the possibility a patient will slip into a coma, or unconscious state. Other side effects may include alterations in liver function, skin reactions, such as rash, and infections may be severe and life threatening. Less serious, and almost always transient side effects, include flu-like symptoms, such as nausea and vomiting.

Interactions

Aldesleukin interacts with drugs that affect the central nervous system and it should not be taken with drugs that are used to modify moods or disposition (psychotropic agents). Many drugs, including those used to control blood pressure, heart beat and kidney function, increase the toxicity of aldesleukin and should not be taken in combination with it. Corticosteroids also interfere with the action of aldesleukin.

Physicians must be informed about every drug a patient is taking so interactions can be avoided.

Diane M. Calabrese

Corticosteroids

—Compounds that are made naturally by the body in the cortex of the adrenal glands and that are also made synthetically, or in the laboratory.

Intravenous line

—A tube that is inserted directly into a vein to carry medicine directly to the blood stream, bypassing the stomach and other digestive organs that might alter the medicine.

Kilogram

—Metric measure that equals 2.2 pounds.

Lymphatic system

—The system that collects and returns fluid in tissues to the blood vessels and produces defensive agents for fighting infection and invasion by foreign bodies.

Metastatic

—Spreading from one part of the body to another.

Milligram

—One-thousandth of a gram, and there are one thousand grams in a kilogram. A gram is the metric measure that equals about 0.035 ounces.

Toxicity

—The quality of acting as a poison.

T cell

—A cell in the lymphatic system that contributes to immunity by attacking foreign bodies, such as bacteria and viruses, directly.