Patient Handout: High-Dose Interleukin-2 (IL-2)

What is High-Dose IL-2?

High-dose Interleukin-2 (IL-2) is a form of immunotherapy used to treat certain cancers, most commonly renal cell carcinoma (kidney cancer) and melanoma. IL-2 is a type of protein that helps regulate the immune system, stimulating white blood cells (specifically T cells and natural killer cells) to fight cancer. High-dose IL-2 is given at higher-than-usual doses to boost the immune system’s ability to destroy cancer cells.

How Does High-Dose IL-2 Work?

IL-2 is a naturally occurring protein that helps the body fight infections and cancers. When administered in high doses, IL-2 activates and boosts the activity of the immune system, especially T cells and natural killer (NK) cells, which play a key role in targeting and attacking cancer cells. By stimulating these immune cells, high-dose IL-2 can help control the growth and spread of cancer.

How is High-Dose IL-2 Given?

High-dose IL-2 is usually given through an intravenous (IV) infusion in a hospital or medical clinic. This means the medication is injected into a vein, and you will receive the treatment under close medical supervision.

• Administration schedule: IL-2 is often administered in cycles. The treatment may be given for several days in a row, followed by a rest period. The exact schedule will depend on your condition and how well you tolerate the treatment.
• In-hospital treatment: You will likely be admitted to the hospital for each cycle of IL-2, as this therapy can cause serious side effects that require close monitoring.

Possible Side Effects

High-dose IL-2 can cause significant side effects. It is important to be aware of these potential effects, as they may require medical attention:

• Common side effects:
  • Fever and chills
  • Fatigue (feeling very tired)
  • Nausea and vomiting
  • Swelling in the legs or ankles
  • Muscle and joint pain
  • Skin rashes
  • Low blood pressure (hypotension)
• Serious side effects (contact your doctor immediately if you experience any of these):
  • Low blood pressure: Severe low blood pressure (hypotension) may occur, causing dizziness, fainting, or shock.
  • Organ damage: IL-2 can affect organs like the heart, kidneys, liver, and lungs. Symptoms include shortness of breath, chest pain, or changes in urination.
  • Fluid retention: Swelling in the body due to fluid retention (edema), especially in the abdomen, legs, or face.
  • Infections: Due to the immune system being activated, infections may occur. Contact your doctor if you develop fever, chills, or signs of infection.
  • Serious allergic reactions: Rare but serious reactions, such as difficulty breathing or swelling of the face, lips, or throat, require emergency medical care.

Precautions

Before starting high-dose IL-2, tell your doctor if you have:

• Heart problems: IL-2 can cause low blood pressure and affect the heart. Let your doctor know if you have heart disease or a history of heart problems.
• Kidney problems: High-dose IL-2 can affect kidney function, so your doctor will monitor your kidney health closely.
• Liver disease: Liver function may also be affected, so liver function tests will be part of your treatment monitoring.
• Lung disease or breathing issues: IL-2 can cause breathing problems, so it’s important to inform your doctor if you have a history of lung disease.
• Infections or weakened immune system: Although IL-2 stimulates the immune system, it can also make you more prone to infections in some cases.
• Pregnancy or breastfeeding: IL-2 may harm an unborn baby. You should not become pregnant or breastfeed while receiving IL-2 therapy. Discuss birth control options with your healthcare provider.

What to Expect During Treatment

• Hospital stay: Due to the potential for serious side effects, most patients receiving high-dose IL-2 will stay in the hospital. You will be closely monitored by your healthcare team throughout the treatment.
• Monitoring: Your healthcare team will regularly check your vital signs, including blood pressure, heart rate, kidney function, and oxygen levels, to make sure your body is responding well to the treatment. Blood tests will be used to monitor your liver and kidney function, as well as your blood cell counts.
• Fluids and electrolytes: IL-2 can cause fluid imbalances, so you may be given intravenous fluids to help manage any swelling or dehydration during treatment.

Drug Interactions

High-dose IL-2 may interact with other medications. Be sure to tell your doctor about all the medications you are taking, including:

• Prescription medications
• Over-the-counter medications
• Herbal supplements or vitamins
• Other cancer treatments

Some medications may interfere with how IL-2 works or increase the risk of side effects. Always discuss any new medications with your doctor.

Emergency Situations

If you experience any of the following serious symptoms, get immediate medical help:

• Severe dizziness, fainting, or confusion
• Difficulty breathing or chest pain
• Swelling of the face, lips, or throat
• Severe headache or vision changes
• Unusual bleeding or bruising
• Decreased urination or signs of kidney problems, like swelling or pain in the lower back

Pregnancy and Breastfeeding

• Pregnancy: High-dose IL-2 may cause harm to an unborn baby. If you are pregnant, plan to become pregnant, or think you might be pregnant, tell your doctor right away. You should avoid becoming pregnant during treatment and use effective birth control methods.
• Breastfeeding: It is not known whether IL-2 passes into breast milk, so you should not breastfeed while receiving treatment.

Lifestyle Tips

• Stay hydrated: Drink plenty of fluids during treatment to help reduce side effects like swelling or dehydration.
• Monitor for signs of infection: High-dose IL-2 can sometimes cause immune activation, leading to an increased risk of infections. Report any symptoms such as fever, chills, or new coughs to your doctor immediately.
• Rest: Treatment with IL-2 can be exhausting, and it’s important to listen to your body. Make sure to rest when needed.

Conclusion

High-dose IL-2 is a powerful treatment used for specific cancers, particularly melanoma and renal cell carcinoma. While it can be highly effective, it requires close monitoring due to the potential for serious side effects. Be sure to follow all instructions provided by your healthcare team, and do not hesitate to reach out to them with any questions or concerns during your treatment.

Disclaimer: This handout is for educational purposes only and is not intended as medical advice. Always consult your healthcare provider for specific medical guidance regarding your treatment.