Chapter 7. Interferons and Cytokines for Anti-Infective and Cancer Therapy

Summary

As the first DNA recombinant technology products effective in cancer treatment, interferons (IFNs) opened an era of biologic therapies for cancer, multiple sclerosis, and infectious diseases. Although more than 40 years have passed since IFNs were first described, scientific and clinical interest in these multifunctional cytokines has not diminished. The mechanisms of antitumor effects, optimal dose, schedule, and type of IFN for specific clinical indications have yet to be fully described. Progress in cloning IFN receptors and other signaling components has allowed further identification and description of molecular pathways by which type 1 and type 2 IFNs mediate their effects. Further characterization and identification of interferon-stimulated genes or factors that mediate IFN-dependent antiproliferative, apoptotic, and immunomodulatory effects will lead to better utilization of IFNs in the treatment of cancer. Anti-infective property of IFNs has provided efficacy against hepatitis B and hepatitis C infection. Although the use of α-IFNs in hepatitis B infection has largely been replaced by oral antiviral drug therapies, IFNs remain the standard of care for treatment of patients with chronic hepatitis C infections. The anti-inflammatory effects of β-IFNs have demonstrated benefits in the treatement of patients with multiple sclerosis. Monographs of IFN therapeutics are included in a later part of this chapter. Innovative approaches such as the introduction of second-generation IFNs with extended biological effects and pharmacokinetic profiles may broaden the therapeutic applications of IFNs over the next decade.