Effects of preoperative recombinant Interleukin 2-based immunomodulation on outcome after gastrointestinal cancer surgery: a systematic review and meta-analysis

BACKGROUND: Patients undergoing gastrointestinal cancer surgery are often immunocompromised and susceptible to infectious complications. Recombinant Interleukin 2 activates effector immune cells and stimulates the expansion of regulatory T-cells, making it a promising intervention for prevention of inflammatory complications. OBJECTIVE: Our objective was to investigate effects of different preoperative rIL2 dosages on postoperative outcome parameters. METHODS: We conducted a systematic literature review and meta-analysis and included RCTs that recruited adult patients undergoing gastrointestinal cancer surgery who received preoperative subcutaneous rIL2. We performed a systematic search of MEDLINE (via PubMed), Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1989 up to April 18th, 2024. RESULTS: ] at 1 week postoperative were higher in the intervention compared to the control group (MD 865 (95%CI: 26, 1705)). Surgical site infections and systemic infections were less likely to occur in the intervention group (OR 0.13 (95%CI: 0.03, 0.50); OR 0.25 (95%CI: 0.10, 0.66)). Severe side effects of rIL2 were not reported. CONCLUSION: Preoperative rIL2-based immunomodulation prevents postoperative immunosuppression while the occurrence of severe side effects does not seem to be relevant.