Interferon alpha 2b recombinant:
Maintenance Therapy for Mesothelioma
Purpose: Maintenance therapy for malignant mesothelioma to inhibit new cancerous tumors from forming and possibly extending the time between recurrences.
Results: When combined with surgery and radiation, Dr. Robert Cameron reports prolonged life expectancy to 37 months on average. Presentation Link
The body’s immune system naturally produces proteins known as interferons, which help fight infections and viruses. Interferon alpha in particular fights infection and also prevents tumor formation.
Tumors grow in the body because blood vessels bring nutrients to them, amongst other factors. Mesothelioma is a cancer known to cause many new blood vessels to form allowing multiple and diffuse tumors to grow and spread through the body. Interferon alpha prevents new blood vessels from growing, which in turn starves tumors and limits their growth.
Just as in their natural function, interferon given as a drug performs these similar roles as cancer therapy. Different types of interferon can be used in conjunction with chemotherapy and radiation to treat many cancers and diseases (such as hairy cell leukemia, AIDS-related Kaposi's sarcoma, genital warts, hepatitis, and non-Hodgkin's lymphoma) to maintain better health for extended periods of time. For the same reasons, using interferon as maintenance therapy for mesothelioma may also extend a patient's healthy life.
How is interferon administered?
Dr. Robert Cameron of UCLA has been treating some mesothelioma patients with a daily low dose of interferon alpha since 2002. Initially, early patients decided whether or not to go into this testing stage of interferon for treatment of their mesothelioma. In treating other diseases, interferon is usually given at higher doses every few days or weeks. However, Dr. Cameron believes that a daily injection of interferon providing a continual dose may improve a patient’s health better than an injection given every few days or once a week.
Each night before going to sleep, the patient injects himself with interferon alpha. The dose is small and many patients start at 1.5 million units. Tylenol may be taken during the first week to help alleviate any side effects. Over time, the body may tolerate the dosage well and the doctor may increase the amount of interferon slowly.
Interferon alpha is given as an injection. Typically there are two forms that the interferon is made available: vial and syringe or through a multidose pen. Patients who use interferon in the vial and syringe must mix the interferon themselves (according to the directions provided) and then withdraw the necessary dose into the syringe before self injecting. The multidose pen requires fewer steps. The patient must select the dose of interferon by turning the cap of the multidose pen to the appropriate dosage setting. Many times, you may hear a clicking noise as you turn the cap a certain number of times to reach your prescribed dose.
Remember, interferon should be kept in the refrigerator. Sometimes the patient can give the shots to himself or someone at home may give the shots. Patients should be sure to know how and when to have their shots and how much medicine to use. Be sure to use the same brand of medicine for the entire treatment. Do not change your dosage without doctor's approval. Use sterile, disposable syringes and needles. Use them only once, and dispose safely following the health care provider's instructions.
Video: For those who will use the multidose pen, please review the video on how to self-inject and then follow up with your treating specialist or a pharmacist if you have more questions: www.introna.com/introna/learning_self_injection.action
Medication Guide: Pharmacies may order Interferon Alpha for use as a vial and syringe or as a multidose pen. Review these options with your doctor and a pharmacist. For details, you may download the medication guide.
Just as with other cancer therapies, interferon alpha injections may cause side effects which occur when healthy tissues are affected by the cancer therapies.
Common side effects include:
- Flu-like symptoms (fever, muscle pain, joint pain, headache, chills)
- Fatigue and low energy levels
- Discomfort related to food and digestion
- Loss of appetite, nausea or vomiting
- Diarrhea
- Dizziness or confusion
- Mood disturbances such as depression
- Other possible changes such as hair thinning, skin discomfort or rash, dry mouth, or altered sense of taste
- Numbness in the hands or feet
- Autoimmunity
Contact your health care provider if any of these become severe. A health care provider may prescribe acetaminophen (Tylenol) to help relieve flu-like symptoms.
This medicine may make patients dizzy or confused. Patients should not drive or operate machinery unless they are fully alert and thinking clearly. Along with its needed effects, this medicine may cause some unwanted side effects which may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your health care provider if you have any side effects that continue or worsen after one week.
Females of childbearing age: This medicine is not usually given during pregnancy. Use reliable birth control during this treatment. Contact your health care provider right away if you become pregnant during treatment. Do not breastfeed during treatment with this medicine.
Diabetics: This medicine may worsen diabetes, but rarely. Contact your health care provider if your condition changes.
When taken with other medicines, interferon can change the way this or any of the other medicines work. Also, using multiple medicines together might cause harmful side effects. Talk to your health care provider, especially if you are taking any of these medicines:
- theophylline and aminophylline
- zidovudine (Retrovir, AZT)
Be sure to tell all health care providers who treat you about all medicines you are taking, including nonprescription products, vitamins, and natural remedies. And remember to keep all medicines out of the reach of children. Do not share medicines with other people.
Speak with your physician or learn more about side effects and how best to manage these side effects at the Schering Plough website: www.introna.com/introna/managing_side_effects.action. Using the navigation on the left side of the menu, get specific instructions on how to manage each side effect.
Who is the prescribing doctor?
A mesothelioma patient may have interferon prescribed through his or her treating specialist. In some cases, this may be an oncologist, for others it could be a surgeon. Dr. Robert Cameron is the prescribing doctor for many of his mesothelioma patients, but not for all of them. Mesothelioma patients should speak with their treating specialist about the benefits of a daily low dose interferon alpha regimen. Specialists who would like more information should contact Dr. Robert Cameron via email or call (310) 231-2130.
Patients will likely need appropriate blood and other laboratory tests before beginning interferon. Make sure you have all appropriate testing completed before beginning the interferon regimen.
Do I qualify for a discount through the Commitment to Care program?
One downside to the maintenance therapy for interferon alpha is the cost. Many patients may pay as much as $20,000 annually for their prescription. Add this to the additional costs of PET/CT scans, chemotherapy, surgery, radiation, doctor visits, and in some cases travel to see your treating specialist, makes mesothelioma a very expensive disease.
For some, there may be financial assistance through the Schering Plough Commitment to Care program. Patients must apply each year for the Commitment to Care program. This program has two divisions, one for oncology and one for hepatitis. Mesothelioma patients should be sure to apply to the oncology division. This program is need-based; therefore patients will have to provide proof of income or proof of no income by attaching W2 forms or pay stubs. Additionally, your prescribing doctor will also have to complete one section of the 2-page application.
In the U.S. complete your application by downloading this Commitment to Care Application and mailing it to:
Commitment to Care, Oncology Program
6900 College Blvd., Suite 1000
Overland Park, KS 66211
Or via Fax: (866) 277-9328
Questions? Call (800) 521-7157.
In Canada, call (877) 494-0454 to speak with a specialist who will mail the appropriate forms to you and your doctor. Hours are Monday – Friday 8 am – 8 pm (eastern).
Schering Plough makes the drug Intron A which is the interferon alpha-2b recombinant that can be used for mesothelioma.
Visit Schering-Plough’s website for more information: www.schering-plough.com. Their website has many useful tools and information on what Intron A is and why it is used. Keep in mind that the website focuses on melanoma mostly, but you may find useful information in the TLC program, as well.