Short Communication: The Efficacy of Fixed Dose Rate Infusion of Gemcitabine Combined with IFN-α2a in Patients with Advanced Refractory Renal Cell Carcinoma

The fixed dose rate (FDR) infusion of gemcitabine is based on pharmacokinetic studies demonstrating an increased peak concentration of gemcitabine-active metabolites inside the cell. In this prospective study, for the first time we investigated gemcitabine FDR infusion together with interferon-α2a (IFN-α) in pretreated patients with advanced renal cell carcinoma (RCC). Twelve patients received 800 mg/m² gemcitabine (i.v. infusion of 10 mg/m²/min) on days 1 and 8 every 3 weeks, combined with 3.0 × 10⁶ U s.c. IFN-α on days 1, 3, and 5 of each week. Median age of patients was 64 years, and the Eastern Cooperative Oncology Group performance status (ECOG PS) was 0–1 in 10 patients. All patients were pretreated, 5 with ≥2 lines of chemoimmunotherapy. A median number of five cycles of gemcitabine per patient were given, with a mean weekly dose intensity of 72% of that planned. Among 11 evaluable patients, 2 (18%) partial responses and 5 (46%) stable diseases (median duration of 9.3 months) were observed. Median time to progression (TTP) and overall survival were 7.1 months and 13.0 months, respectively. The most frequently occurring grade 3 or 4 adverse events were leukoneutropenia (25%), thrombocytopenia (17%), and diffuse edema (25%). One patient developed a cerebrovascular accident potentially related to treatment. These promising results with the combination of gemcitabine infused at FDR and IFN-α deserve further investigation.