Why Proleukin® Therapy for Metastatic Melanoma and Metastatic Renal Cell Carcinoma?

In both metastatic melanoma and metastatic renal cell carcinoma, disseminated disease is associated with a poor prognosis. Substantial mortality rates can be expected, ranging from 95% in metastatic melanoma to 90% to 97% over 5 years in metastatic renal cell carcinoma. Unfortunately, treatment options for patients with metastatic melanoma and metastatic renal cell carcinoma are often limited, and optimal management strategies have yet to be defined.

In clinical trials, Proleukin (aldesleukin) for injection therapy produced durable, complete responses among a subset of metastatic melanoma and metastatic renal cell carcinoma patients for more than 10 years.

clinical response carcinoma

clinical response melanoma

Proleukin Therapy Offers Fast Answers

Speed of response is an important consideration in metastatic disease. In clinical trials among metastatic melanoma and metastatic renal cell carcinoma patients, onset of tumor regression was observed as early as 4 weeks after completion of the first course of treatment, and in some cases continued for up to 12 months after the start of treatment.

Treatment with Proleukin is initially based on two, 5-day cycles that constitute 1 course of therapy. Patients who respond to Proleukin can go on to receive additional cycles, while non-responders are typically eligible for other treatment options.

The ability to quickly identify a subset of patients not responding to Proleukin therapy is important because it allows timely reassessment of subsequent treatment options.

Proleukin® (aldesleukin) is indicated for the treatment of adults with metastatic renal cell carcinoma or metastatic melanoma.

IMPORTANT Safety Information

Therapy with Proleukin® (aldesleukin) should be restricted to patients with normal cardiac and pulmonary functions as defined by thallium stress testing and formal pulmonary function testing. Extreme caution should be used in patients with a normal thallium stress test and a normal pulmonary function test who have a history of cardiac or pulmonary disease.

Proleukin should be administered in a hospital setting under the supervision of a qualified physician experienced in the use of anticancer agents. An intensive care facility and specialists skilled in cardiopulmonary or intensive care medicine must be available.

Proleukin administration has been associated with capillary leak syndrome (CLS) which is characterized by a loss of vascular tone and extravasation of plasma proteins and fluid into the extravascular space. CLS results in hypotension and reduced organ perfusion which may be severe and can result in death. CLS may be associated with cardiac arrhythmias (supraventricular and ventricular), angina, myocardial infarction, respiratory insufficiency requiring intubation, gastrointestinal bleeding or infarction, renal insufficiency, edema, and mental status changes.

Proleukin treatment is associated with impaired neutrophil function (reduced chemotaxis) and with an increased risk of disseminated infection, including sepsis and bacterial endocarditis. Consequently, preexisting bacterial infections should be adequately treated prior to initiation of Proleukin therapy. Patients with indwelling central lines are particularly at risk for infection with gram positive microorganisms. Antibiotic prophylaxis with oxacillin, nafcillin, ciprofloxacin, or vancomycin has been associated with a reduced incidence of staphylococcal infections.

Proleukin administration should be withheld in patients developing moderate to severe lethargy or somnolence; continued administration may result in coma.

Proleukin® (aldesleukin) Side Effects

The following adverse events (Grades 1-4) were seen in ≥30% of 525 patients (255 with metastatic renal cell cancer and 270 with metastatic melanoma) treated with Proleukin®: hypotension (71%), diarrhea (67%), oliguria (63%), chills (52%), vomiting (50%), dyspnea (43%), rash (42%), bilirubinemia (40%), thrombocytopenia (37%), nausea (35%), confusion (34%), and creatinine increase (33%).

Because of the severe adverse events which generally accompany Proleukin therapy at the recommended dosages, thorough clinical evaluation should be performed to identify patients with significant cardiac, pulmonary, renal, hepatic, or CNS impairment in whom Proleukin is contraindicated. Patients with normal cardiovascular, pulmonary, hepatic, and CNS function may experience serious, life threatening or fatal adverse events. Adverse events are frequent, often serious, and sometimes fatal.

In patients receiving single-agent Proleukin (255 with metastatic renal cell carcinoma and 270 with metastatic melanoma), the rate of drug related deaths was 4% (11/255) in mRCC patients and 2% (6/270) in mM patients.

Survival benefit has not been demonstrated.

Please see complete prescribing information, including BOXED WARNING.

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