Reduction of plasma levels of soluble tumor necrosis factor and interleukin-2 receptors by means of a novel immunoadsorption column.
This non-randomized open clinical study investigated the safety and efficacy of extracorporeal fractionated plasma adsorption using the Oncosorb immune adsorption column. The column selectively bound soluble tumor necrosis factor receptors 1 and 2 (sTNF-R1 and sTNF-R2) and soluble interleukin-2 receptors (sIL2-R) by lowering plasma levels in patients with metastatic cancer. Nine patients (three men and six women; mean age 48 years, aged 41-68 years) with metastatic cancer received at least 12 immune adsorption procedures. Thrice-weekly immune adsorption separated a low molecular weight (150 000 D) plasma fraction from the patients' blood, passing the plasma fraction through the column in an extracorporeal plasma perfusion circuit. Respective plasma receptor mean concentrations before and after 167 procedures were: sTNF-R1: 1936 +/- 788 pg/mL before treatment vs. 1312 +/- 989 pg/mL after treatment; sTNF-R2: 3140 +/- 1173 pg/mL before treatment vs. 1816 +/- 1 +/- 1677 pg/mL after treatment (P < 0.01 for each inhibitor). Mean reductions in sTNF-R1 (48%), sTNF-R2 (55%), and sIL2-R levels (72%) were observed for treatments 3-12 (P < 0.001). Clinical findings indicated tumor inflammation and necrosis in most patients. Side-effects were low-grade fever, flu-like symptoms; tumor pain and redness, warmth, tenderness, and edema. The column demonstrated safety and efficacy in lowering plasma sTNF-R1, sTNF-R2, and sIL2-R levels. Minor clinical adverse effects common to the use of extracorporeal devices were seen.