Experience of cytokine therapy in the treatment of recurrent cervical cancer

Abstract

Cervical cancer is the most common malignant tumor of the female genital organs. In general, the prognosis in patients with advanced cervical cancer is unfavorable. The option of choice for stage IV of the disease and relapses is systemic platinum-containing chemotherapy. Its effectiveness is about 20-26%, life expectancy is 12 to 13 months. Undoubtedly, the search and development of new methods of treating this disease is an extremely urgent task. Immuno-oncology has emerged as a potential new strategy to improve the treatment outcomes of patients with malignant neoplasms. Much attention in research is focused on the opportunity of using interleukin-2, tumor necrosis factor (TNF) and interferon-gamma (IFNγ) for tumor immunotherapy, since these cytokines play a special role in antitumor protection. Due to the active search for new hybrid molecules based on TNFα, some domestically developed recombinant antitumor drugs are implicated into modern practice of clinical oncologists, in particular, “Refnot” (TNFα-thymosin-α1) and “Ingaron” (IFNγ preparation). We analyzed the result of combined treatment (standard polychemotherapy at the 1st line augmented with cytokinotherapy including Refnot + Ingaron therapy) in one patient with recurrent cervical cancer. According to the control examination, upon completion of the polychemotherapy course, a complete tumor response was registered according to the Recist 1.1 criteria. The patient continued to receive cytokines as supporting therapy. Currently, according to control quarterly examinations, a complete regression of recurrent tumor persists from the end of polychemotherapy to 28 months of observation. One should note that when monitoring the state of the immune system during therapy with Refnot and Ingaron, we noted an increase in absolute and relative numbers of T cells to normal levels along with higher cytotoxic and antitumor potential of NK cells without increasing their number. The patient well tolerates the therapy, improved quality of life is documented, and there are no clinically significant side effects. Hence, the therapy with “Refnot” (TNFα-thymosin-α1) and “Ingaron” (IFNγ) in this clinical case proved to be a safe method of maintenance therapy with a positive therapeutic effect thus allowing effective control of recurrent cervical cancer for more than 2 years, as well as significantly improve quality of life of the patient. This type of therapy may be recommended for usage in clinical oncology.