Sistemsko zdravljenje z interferoni v onkologiji Systemic treatment with interferones in oncology

Abstract

Interferoni so pomembni za komunikacijo med celicami, ki so vključene v obrambo našega imunskega sistema. V onkologiji jih predpisujemo pri zdravljenju različnih rakov, v predpisanih odmerkih. Najpomembnejšo vlogo imajo v adjuvantnem zdravljenju malignega melanoma pri velikih odmerkih z interferonom- -α2b tipa. Maligni melanom je v več kot 80 odstotkih ozdravljiva bolezen, če se kirurško odstranjuje v zgodnjih fazah. V primeru pozitivnih regionalnih bezgavk se v več kot polovici teh bolnikov razvije metastatska bolezen, ki je neozdravljiva. Pri bolnikih z večjo verjetnostjo ponovitve bolezni v stadijih IIB, IIC in III se tako priporoča adjuvantna terapija z visokim odmerkom interferona- α2b v Evropi, v stadiju IIIA z visokim tveganjem (velikost metastaze v regionalni bezgavki > 1 mm) in v stadijih IIIB in IIIC pa v ZDA priporočajo zdravljenje z visokim odmerkom anti-CTLA monoklonalnega protitelesa ipilimumaba. Neželeni učinki visokega odmerka interferona so obvladljivi z dobro edukacijo in s sodelovanjem bolnikov.

Abstract (Eng)

Interferons are an integral part of communication between the cells responsible for triggering the protective defenses of our immune system. In oncology, they are administered in prescribed doses to treat different cancers. They are of utmost importance in adjuvant treatment of malignant melanoma, namely in high doses of interferon α2b. Malignant melanoma is a highly aggressive malignant disease that is curable in more than 80 % of patients, if surgically removed in early stages of the disease. If, upon detection, regional lymph nodes are already positive, an incurable metastatic disease develops in more than 50 % of patients. For patients with a greater possibility of disease recurrence (stages IIB, IIC, and III), adjuvant therapy with a high dose of interferon α2b is recommended in Europe; while for high-risk stage IIIA (node metastasis > 1 mm) and stages IIIB and IIIC, a high dose of the anti-CTLA monoclonal antibody ipilimumab is recommended in the United States. The side effects of a high dose of interferon are manageable with a well-educated and compliant patient.