Aldesleukin [Specialist drug]

How it works

It is a recombinant form of interleukin-2 that stimulates proliferation and activation of T-lymphocytes and natural killer cells to promote an antitumour immune response.

Prescribing in practice

• It can cause capillary leak syndrome with hypotension, oedema and organ hypoperfusion, so it must be given in a specialist setting with close haemodynamic monitoring.
• It is contraindicated in significant cardiac, pulmonary, renal or hepatic impairment and in those with autoimmune disease or organ transplants because of severe toxicity.
• Treatment requires intensive supportive care and careful patient selection given its narrow tolerability.

Monitoring

Monitor blood pressure, fluid balance, organ function and for signs of capillary leak and infection closely throughout treatment.

Counselling the patient

• This treatment is given under close hospital supervision because it can cause serious effects on blood pressure and organs.
• Report breathlessness, swelling, confusion or feeling very unwell promptly.
• Your team will explain the intensive monitoring required during each course.

Evidence & guidelines

Aldesleukin is an established high-dose immunotherapy option for selected patients with metastatic renal cell carcinoma and melanoma.