[Long-term results in the treatment of metastasizing kidney carcinoma using recombinant alpha-2 or gamma interferon]

To evaluate whether response to alpha-2- or gamma-interferon in metastatic renal cell carcinoma is associated with a prolonged survival, we studied a total of 65 patients being treated in two phase-II- or phase-III-trials between 1984 and 1986 with one of these interferons. After a median follow-up of 3 years for the alpha-interferon-treated patients and of more than 4 years for gamma-interferon-therapy, respectively, there is a significantly increased duration of survival for patients showing an objective response or stabilisation of the disease due to either therapy compared to those with continuing progression. Therapy with alpha-interferon leading to objective remissions in 26% or with gamma-interferon with an objective response rate of 36% therefore is beneficial for responding patients and can be performed with moderate side effects on an out-patient basis.

[Use of electronic data processing at a urologic polyclinic--a program packet for recording and evaluating data of specialized consultations]

A software package was developed for computerized recording and processing of clinical data in a urological out-patient clinic. In a pilot study this program proved to be useful for the rapid evaluation of all important clinical and laboratory results of patients with renal cell carcinoma, and its use also accelerated the preparation of medical reports. The experience gained in this initial project shows that the application of this newly developed concept of data processing can easily be extended to routine out-patient followup in other special areas within the field of oncology.

Recombinant interferon gamma in the treatment of metastatic renal cell carcinoma. Results of a phase II trial

A clinical Phase II study was performed to evaluate the efficacy and safety of treatment with interferon gamma in patients with metastatic renal cell carcinoma. Patients received interferon gamma by two different regimens: 1. 100 micrograms/m2 3x/week i.v. over 4 h every other week--low dose. 2. 500 micrograms/m2 5x/week i.v. over 24 h every other week--high dose--for non-responders to regimen 1. The response rate, duration of response, survival and toxicity in the two regimens were evaluated. Treatment with interferon gamma resulted in an overall response rate of 31%, with a duration of response ranging between 2 and 44+ months. Patients responding objectively to interferon gamma or showing stable disease survived significantly longer than non-responders (p = 0.0056).

[Treatment of metastatic kidney cancer with recombinant alpha-2 or gamma interferon. Results of 2 clinical phase II and III studies]

In a phase-II and a phase-III study patients with histopathologically documented metastatic renal cell carcinoma were treated either with gamma-interferon in two different doses (100 micrograms/m2 3x/week for 4 h i.v. every other week or 500 micrograms/m2 5x/week for 24 h i.v. every other week) or with alpha-2-interferon alone (18 x 10(6) U 3x/week weekly i.m.) or in combination with vinblastine (0.1 mg/kg every third week i.v.). The purpose of these studies was to evaluate the response rate, the duration of response, the survival, the efficacy and the toxicity of the different forms of treatment. The overall response rate to gamma-interferon was 30% in both regimens. The response rate of treatment with alpha-2-interferon was found to be 31%. The duration of response ranged between 2 and 34+ months in patients treated with gamma-interferon and between 2 and 24+ months in those receiving alpha-2-interferon. Patients with objective tumor response showed a significantly longer survival than those not responding (p = 0.0056). Low-dose-gamma-interferon and alpha-2-interferon treatment could be easily done on an outpatient basis. In conclusion, interferon treatment seems to be of value in the therapy of patients with well documented progressive disease in metastatic renal cell cancer.

Transcutaneous bilirubin measurements in full-term infants

A total of 292 transcutaneous bilirubin (TcB) measurements were performed in 157 white full-term infants: 157 were obtained from the forehead and 135 from the midsternum. TcB measurements correlated well with serum bilirubin determinations (r = .93, P less than .0001). The sensitivity of the test was 100% and the specificity 97%. It was possible to establish guidelines for the TcB measurement which identified all infants whose serum bilirubin concentrations exceeded 12.9 mg/100 ml (221 mumoles/liter) with no false-negative and only five false-positive determinations (3%). The positive predictive value for the TcB measurements was 58%. This implies that, in our population, an infant with a TcB index greater than or equal to 24 has a 58% chance of having a serum bilirubin concentration greater than 12.9 mg/100 ml. The negative predictive value was 100%. Thus, a negative test will correctly predict the absence of hyperbilirubinemia in all cases. As these measurements were obtained prospectively in a well-baby population with a prevalence of hyperbilirubinemia (greater than 12.9 mg/100 ml) of 4.5%, the positive predictive value should be applicable to other similar populations and will, in fact, increase in populations with a higher prevalence of hyperbilirubinemia. TcB measurements can be recommended for the identification of significant neonatal jaundice in full-term infants. It is important to recognize, however, that because of potential variations in TcB meters as well as serum bilirubin measurements in different laboratories, each institution should establish its own criteria for the use of this instrument.