Acute infections in interferon-treated patients with osteosarcoma: preliminary report of a comparative study

Betaferon® – Ab Ovo

Es war einmal der Wunsch, die Replikation von Viren besser zu verstehen oder gar zu entschlüsseln, um wirksame Präparate gegen virale Erkrankungen zu entwickeln. Paul Ehrlich hatte bereits 1908 die antibakterielle Wirkung von Arsphenamin und damit das erste Medikament gegen Syphilis, Alexander Fleming 1928 das Penicillin und Gerhard Domagk 1935 die Sulfonamide entdeckt. Alle drei erhielten für ihre Entdeckungen Nobelpreise und retteten mit ihren Entwicklungen wahrscheinlich Millionen von Menschen das Leben.

Interferon therapy in neoplastic disease. A preliminary report

The treatment of 10 patients having neoplastic disease with exogenous i.m. interferon therapy is described. The interferon given is partially purified interferon produced from human leukocytes. Sendai virus is used as interferon inductor. The patients reported in this paper have been on treatment for periods of 2-28 months. Apart from initial periods of fever, no side-effects have been recorded. Patients suffering from bladder papillomas have shown partial regression after a few months of therapy. The other cases treated are too few to warrant any conclusions, but the therapy does seem to have been beneficial.

Interferons and osteosarcoma

In 1970, we initiated studies at the Karolinska hospital to find out whether biologically meaningful doses of interferon (IFN) alpha preparations could be administered systemically to patients with viral and tumour diseases without causing unacceptable side effects. Antiviral and antitumour efficiency was demonstrated. Only a limited number of patients were injected due to shortage of high dose IFN preparations. Osteosarcoma patients participated in these early attempts. Due to clinical observations on one patient and due to lack of meaningful systemic standard treatment for osteosarcoma at the time, we decided to continue to give adjuvant IFN treatment to a consecutive series of osteosarcoma patients attending our hospital . We were encouraged by the preliminary follow up results of the series and continued to use this therapeutic principle up to 1990. The clinical results achieved are briefly summarized in this mini-review as are the results obtained in simultaneously ongoing model experiments in vitro and in vivo. A randomized large scale ongoing trial, involving the use of adjuvant IFN treatment of osteosarcoma patients, has been initiated by the European and American osteosarcoma study group 35 years after the first osteosarcoma patient received IFN. The trial is briefly outlined in this article.

Adjuvant interferon treatment of human osteosarcoma

This paper updates the results of the clinical trial to examine the efficacy of exogenous leukocyte interferon therapy as adjuvant treatment for osteosarcoma. So far the incidence of metastases is lower and the survival rate is better for the interferon-treated group than for the concurrent control group. The number of treated patients is too small at present to allow proper statistical calculations to be made.

Current report on the interferon program at Roswell Park Memorial Institute

An overview of the interferon program at Roswell Park Memorial Institute (RPMI), is presented. This program encompasses three interrelated areas of research and new drug development: (a) basic research on purification and characterization of animal and human interferons (leukocyte, fibroblast, and immune); (b) large scale manufacture and preclinical testing of human fibroblast interferon (HFIF); and (c) clinical trials with HFIF to determine its safety of administration as well as antiviral, antitumor, and immunomodulatory activities in patients with neoplastic or viral disease. The antitumor effect of HFIF produced at RPMI as assessed by intralesional injection of various metastatic nodules resulted in an overall 71% local response. Phase I studies in 13 patients demonstrated that HFIF can be administered safely by the subcutaneous, intramuscular, and intravenous routes in doses up to 25 million units per day without any serious untoward effects. Intrathecal administration of HFIF into patients with CNS leukemia was also well tolerated. Pharmacokinetic studies indicated significant levels of HFIF in serum and cerebrospinal fluid after intravenous and intrathecal administration, respectively. Coincidental with the HFIF systemic administration during the Phase I trials, favorable responses in several laboratory, immune, and clinical parameters were observed. These results provide the rationale for conducting phase II and phase III clinical trials with HFIF produced at RPMI.

Virus infections and recurrence of osteosarcoma in patients receiving human leukocyte interferon

Human leukocyte interferon was given as adjuvant treatment for osteosarcoma in 26 patients. Blood from these patients was studied at regular intervals for antibodies to various micro-organisms. A continuous record of clinically manifest infections during the course of interferon therapy was made in 23 of the 26 patients. Distant metastases arose in 14 patients - the metastasis group. The report presents comparisons between these patients and the non-metastasis group. Seroconversion in tests with any of the studied micro-organisms was not common. Most of the seroconversions were not associated with clinical symptoms. Seroconversion during interferon therapy was confined to patients in the metastasis group. In some cases there was a chronologic link with early evidence of metastasis. The results of the serologic investigations are discussed and are correlated to the course of interferon therapy and of the neoplastic disease.

Double-blind study of interferon administration in renal transplant recipients

In a double-blind trial renal allograft recipients were treated with fibroblast interferon preparations for 3 months in an attempt to prevent viral infections. Interferon therapy did not reduce the overall incidence of viral infections. No adverse effects were noted on liver function, platelet counts, or leucocyte counts, or acute rejection episodes.

Aging in vitro and large-scale interferon production by 15 new strains of human diploid fibroblasts

To develop resources for large-scale production of human fibroblast interferon, we isolated, cryopreserved, and characterized 15 new strains of human diploid foreskin fibroblasts. Their life spans in vitro ranged from 52 to 72 population doublings. We based the selection of cell strains for mass interferon production on the number of population doublings during which consistently high yields of interferon were obtained after "superinduction" in roller bottles; our data show that aging in vitro leads to significant decline in amounts of interferon produced. In contrast, susceptibility to interferon remains largely unaffected by in vitro senescence. Karyotypic analysis indicated that the best interferon-producing strain, MLD (over 60,000 reference units/ml), has a translocation between chromosomes 5 and 15.