摘要

Tumor necrosis factor-alpha (TNF-alpha) has been discussed as a potential anticancer agent for many years, however initial enthusiasm about its clinical use as a systemic agent was curbed due to significant toxicities and lack of efficacy. Combination of TNF-alpha with chemotherapy in the setting of hyperthermic isolated limb perfusion (ILP) has provided new insights into a potential therapeutic role of this agent. The therapeutic benefit from TNF-alpha in ILP is thought to be not only due to its direct anti-proliferative effect, but also due to its ability to increase penetration of the chemotherapeutic agents into the tumor tissue. New concepts for the use of TNF-alpha as a facilitator rather than as a direct actor are currently being explored with the goal to exploit the ability of this agent to increase drug delivery and to simultaneously reduce systemic toxicity.
This review article provides a comprehensive overview on the published previous experience with systemic TNF-alpha. Data from 18 phase I and 10 phase II single agent as well as 18 combination therapy studies illustrate previously used treatment and dose schedules, response data as well as the most prominently observed adverse effects. Also discussed, based on recent preclinical data, is a potential future role of systemic TNF-alpha in combination with liposomal chemotherapy to facilitate increased drug uptake into tumors.

  • 出版日期2011-10