Aldesleukin
Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)
Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)High alert
An error with this medicine can cause serious harm: double checks and protocols are used.
Recombinant interleukin-2 given at high dose in hospital for metastatic kidney cancer and melanoma. Hallmark danger: capillary leak syndrome.
Also called: recombinant interleukin-2, IL-2
Quick facts
- Group
- Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)
- Target
- Interleukin-2 receptor on T cells and NK cells
- Used for
- Metastatic renal cell carcinoma
- Key effects
- Fever · Nausea · Itchy rash
- Monitor
- Blood pressure · Oxygen saturation and breathing
- ATC
- L03AC01
No doses: the clinician sets them by the current guideline.
Mechanism of action
The crystal structure shows natural human IL-2 bound to its three receptor chains (α, β and common γ); aldesleukin is a slightly modified recombinant IL-2 that acts on the same receptor.
Aldesleukin has the biological activities of natural IL-2. It binds the IL-2 receptor on T lymphocytes and natural killer cells, driving their proliferation, activation and cytotoxicity and the release of other cytokines, so the immune system attacks the tumour. A small group of patients obtain long-lasting responses.
- Recombinant IL-2 binds the IL-2 receptor
- T cells and NK cells multiply and are activated
- Activated cells attack the tumour
- Cytokine release causes capillary leak
Indications
- Metastatic renal cell carcinoma in adults. Renal cell carcinoma →
- Metastatic melanoma in adults. Melanoma →
Adverse effects
Common
- Fever, chills, malaise
- Nausea, vomiting, diarrhoea
- Itchy rash
- Fatigue, confusion
- Low platelets, abnormal liver tests
Contraindications
- Abnormal heart, lung, kidney or liver function before starting
- Caution with organ transplant, seizures, autoimmune disease and prior serious gastrointestinal bleeding
Key interactions
- Antihypertensives, including beta blockers
- Add to the low blood pressure of capillary leak.
- Corticosteroids
- Listed as interacting in the patient information; any use, including skin creams, is reviewed with the oncology team.
- Kidney- or liver-toxic drugs, sedatives and opioids
- Add to organ toxicity or to the central nervous system effects.
What is monitored
- Blood pressure, pulse, weight, fluid balance and urine output closely during each cycle
- Oxygen saturation and breathing
- Level of consciousness
- Kidney and liver tests, electrolytes and blood counts
- Heart and lung function tests before treatment
Administration and safety
- Given only in a hospital with intensive care support, under a physician experienced in cancer treatment.
- Intravenous infusion; reconstitution and dilution follow the product instructions exactly.
- Treatment cycles are held or stopped for severe toxicity rather than pushed through.
Pregnancy and breastfeeding
Pregnancy is discussed with the team before treatment and reported at once if it occurs; breastfeeding is avoided during treatment.
Nursing care
- Monitor blood pressure, heart rate and urine output frequently; report hypotension or oliguria at once.
- Weigh daily and check for oedema and breathing difficulty.
- Assess mental status each shift: report sleepiness or confusion.
- Teaching: report chest pain, shortness of breath, mood changes or severe drowsiness; most effects reverse after the drug is stopped.
Pharmacokinetics
- Absorption
- Intravenous infusion in hospital, in cycles.
- Elimination
- Short half-life; cleared by the kidney as inactive metabolites.
Test yourself
Think of the answer, then tap the question to see it.
What is aldesleukin?
Recombinant human interleukin-2.
Which two metastatic cancers is aldesleukin approved for?
Renal cell carcinoma and melanoma.
What is the main toxicity of high-dose aldesleukin?
Capillary leak syndrome.
Why must high-dose IL-2 be given in a hospital with intensive care support?
Because capillary leak can cause severe hypotension, respiratory failure and kidney failure.
Connections
← Back to the class: Other cancer immunotherapies (cytokines, cell vaccines, oncolytic viruses)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Aldesleukin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Aldesleukin - NCI (National Cancer Institute, 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.