What you are looking at is a table of data from a landmark paper published in The Annals of Surgery in October 1989, the very same month I was diagnosed with metastasis. In black and white, this is the data which saved my life.
The table shows the length of response in patients with kidney cancer who were treated with either high dose Interleukin-2 + “LAK Cells,” or with high dose Interleukin-2 alone. “CR” means “Complete Response” – all detectable cancer disappeared, and “PR” means “Partial Response” – roughly speaking, at least a 50% shrinkage, but with some residual tumor detectable. The table shows the outcome at the time of publication in only those patients fortunate enough to respond to the treatment (most patients didn’t respond at all).
Elsewhere in the paper, the response rate in kidney cancer patients for the IL-2 + LAK combination was reported to be 35%, but the response rate for IL-2 alone was only 22%. Naturally I wanted to get the LAK + IL-2 combination, but Dr. Mary Todd, my oncologist, pointed out to me that despite the higher response rate for IL-2 + LAK, almost all of these patients had relapsed, while not even one of the patients who responded to IL-2 alone had relapsed! She could tell because of the “+” signs. A “+” sign after the response duration means the response was still ongoing as of the patient’s last follow-up. The lack of a “+” means the patient’s remission ended after the given number of months.
These preliminary data were a strong hint that IL-2 was changing the survival curve for people with my cancer to include a small but very real chance of long term survival, and maybe even cure. But back in October 1989, there was no guarantee that these responses would continue to hold in the future. And in fact, over the very long term, quite a few responses did not hold, but many others did, and this treatment does appear to have changed the survival curve. No one wants to have to gamble their life on a hint. But when a solid hint is the only thing you’ve got, that’s exactly what you have to do to maximize your odds.
I still considered the 22% response rate to be too low and so I bet on a combination of Interleukin-2 and Interferon at high dose based on another hint in the same paper that this combination was getting a high response rate in early trials. While the high response rate didn’t seem to hold up in later trials, I was fortunate in that it turned out my response, like some of those from Dr. Rosenberg’s IL-2 + Interferon studies, did hold. If I were placed in this table today, I would be “150+”!
This CancerGuide Page By Steve Dunn. © Steve Dunn
Page Created: 2002, Last Updated: Mar 21, 2002