Thirty-six patients with histologically verified midgut
carcinoid tumours and liver
metastases were included in a prospective study with daily
interferon therapy 5 x 10(6) IU s.c. for one or two years. All had the primary tumour removed at
laparotomy, and whenever technically possible, an embolization of the hepatic arteries was performed prior to
interferon start. Recombinant human alpha 2b
interferon from Schering-Plough was employed. When
interferon was given alone, 24% responded after one year, judged from a 50% reduction in excretion of 5-hydroxyindoleacetic
acid in the urine. Three patients had died. Stable disease was found in 43%, while 19% progressed. Survival rate was 40% after 5 years from start of
therapy. The median survival time from start of
therapy was 3 years and 4 months. When embolization of the liver arteries had been performed prior to the start of
interferon treatment, the response rate was 60% after one year, 20% had stable disease and 20% progressed. Survival rate was 75% up to 5 years of observation. We conclude that
interferon is an effective treatment of malignant metastatic midgut
carcinoid and that survival might be prolonged compared with historical controls. Embolization of the liver arteries seems to increase the response rate after one year. Kaplan-Meier plots suggest prolonged survival when
interferon treatment is combined with embolization.