Nineteen patients with histologically verified midgut
carcinoid tumours and liver
metastases were included in a prospective study with daily
interferon therapy 3 mill IU x m-2 subcutaneously for one year. 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 was employed. When
interferon was given alone for one year 40% responded, judged from either a 50% reduction in excretion of 5-hydroxy-indoleacetic
acid in the urine or a 50% reduction in the area of the largest liver
metastasis, as evaluated by computer tomography. One patient died later on and one withdrew from
therapy of her own will; both were responders at the evaluation at 6 months. When prior embolization of the liver arteries had been performed, the response rate was 85% after one year. When diarrhoea and/or
flushing was evaluated, 70% had response on
interferon alone, while all patients experienced improvement after the combined procedure. We conclude that
interferon is an effective treatment of malignant metastatic midgut
carcinoid and that embolization of the liver arteries seems to increase the response rate.