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Serum Level of Interleukin 6 as a Prognosis Factor in Metastatic Renal Cell Carcinoma¹

Departement of Immunology and the Departement of Medical Oncology, Centre Léon Bérard, 28, rue Laennec, 69008 Lyon [J-Y. B., S. N., V. C., S. A., E. G., Y. M., T. P., M. F.]; Intensive Care Unit, Pavillon P, Hopital E. Herriot, Place d'Arsonval, 69003 Lyon [J-Y. B., A. M., J-F. M.]; Departement of Medical Oncology, Fondation Bergonié, Rue de St-Genes, 33000 Bordeaux [A. R.]; and Departement of Medecine, Laennec Hospital, Rue de Sèvres, 75007 Paris [J-M. T.], France

Interleukin (IL) 6 was measured in the serum of 138 patients with metastatic renal carcinoma before the initiation of IL-2 treatment. IL-6 was detectable in 66 patients with renal cancer (48%) and in only 8 of 70 normal adults (11%). Serum C reactive protein (CRP) and IL-6 levels are correlated, suggesting that IL-6 is involved in CRP increase in these patients. The interval between diagnosis of the primary tumor and metastasis was shorter in patients with a detectable serum IL-6 and/or serum CRP level >50 mg/liter. Serum IL-6 and CRP levels were higher in subgroups of patients previously defined as having a poor life expectancy according to the Eastern Cooperative Oncology Group criteria.

Pretreatment concentrations of IL-6 and CRP were higher in patients who experienced progressive disease after IL-2 treatment. Patients with detectable IL-6 had a shorter survival from the beginning of IL-2 treatment than patients without circulating IL-6 (median, 8 versus 16 months). Similarly, the median survival from the beginning of IL-2 therapy of patients with CRP levels >50 mg/liter was 6 months, compared to 16 months in those with CRP levels below this threshold. None of the 21 patients with serum IL-6 concentrations >300 pg/ml achieved response to any of the three IL-2 regimens. This subgroup has a median survival of 5 months after IL-2 treatment and consisted of 15% of the patients in our series. These results indicate that serum IL-6 and CRP levels are adverse prognosis factors in patients with metastatic renal cell carcinoma. Serum IL-6 level could help in the selection or stratification of the patients in future IL-2 trials.

¹ Supported by Le Comité de Savoie de la Ligue contre le Cancer, le Comité du Rhone de la Ligue contre le Cancer, Le Comité de la Drome de la Ligue contre le Cancer, and la Région Rhone-Alpes.

² To whom requests for reprints should be addressed, at Laboratoire d'Immunologie, Centre Leon Berard, 28, rue Laënnec, 69373 Lyon cedex 08, France.

Received 1/10/92. Accepted 4/ 6/92.

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