Randomized clinical trial of the effect of interferon α on survival in patients with disseminated midgut carcinoid tumours

Background: Midgut carcinoid tumours often present with widespread disease making curative surgery impossible. Medical treatment therefore plays a major role in the treatment of these patients. Methods: In this prospective randomized study, the effect of interferon (IFN) alpha on survival and risk of tumour progression was evaluated in 68 patients with midgut carcinoid tumours metastatic to the liver. All patients had undergone primary surgical treatment and hepatic arterial embolization of liver metastases before randomization. Patients were randomized to treatment with either octreotide alone (n = 35) or octreotide in combination with IFN-alpha (n = 33). Results: Forty-one of the 68 patients died during a follow-up period of 33-120 months, equivalent to a 5-year survival rate of 46.5 per cent. There was no significant difference in survival between patients treated with octreotide alone (5-year survival rate 36.6 per cent) and those given octreotide in combination with IFN-alpha (56.8 per cent). However, patients treated with IFN-alpha had a significantly reduced risk of tumour progression during follow-up (P = 0.008). Conclusion: Addition of IFN-alpha to octreotide may retard tumour growth in patients with midgut carcinoid tumours.