Short-term preoperative IL-2 immunotherapy in operable pancreatic cancer: a randomized study.

Background/aims: A cell-mediated immunodeficiency is demonstrated to occur in advanced cancer patients. Lymphocytopenia predicts a poor prognosis, moreover, the surgical trauma can worsen the impaired immune surveillance and favor disease recurrence. This study investigates the effectiveness of preoperative interleukin-2 administration to improve lymphocyte counts' postoperative recovery in pancreatic cancer.

Methodology: 31 patients with pancreatic cancer who underwent radical surgery were randomized according to 3 different groups. Group A: 9 patients treated with human recombinant IL-2 subcutaneously at 9 million IU/day for 3 days before surgery; group B: 9 patients treated with IL-2 at 12 million IU/day for 3 days before surgery; group C: 13 patients treated with surgery alone. Assessment of total and T helper lymphocyte counts were studied at hospital admission and in 7th and 14th postoperative day.

Results: Toxicity of IL-2 treatment was mild in all groups. Postoperative lymphocytopenia was observed in group A and C, without statistical differences, whereas group B had mean lymphocyte levels within the normal values in the postoperative period.

Conclusions: This preliminary result suggests that preoperative subcutaneously IL-2 immunotherapy at 12 million IU for 3 consecutive days before surgery is able to abrogate the effects of the surgical trauma and recover a normal immunofunction in pancreatic cancer patients.