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Interferon in metastatic renal cell carcinoma
1Department of Radiotherapy and Medical Oncology, The Norwegian Radium Hospital, Oslo.
Seminars in Oncology
|April 18, 2000
Summary
Recombinant interferon-alpha (IFN-alpha) is a standard treatment for metastatic renal cell carcinoma, offering modest survival benefits and a 15% response rate. Side effects are common, and combination therapies are still investigational.
Area of Science:
- Oncology
- Immunotherapy
- Pharmacology
Background:
- Metastatic renal cell carcinoma (MRCC) is an immunoresponsive cancer.
- Recombinant interferon-alpha (IFN-alpha) has been investigated for MRCC treatment.
Purpose of the Study:
- To review the efficacy and role of interferons (IFNs) in treating MRCC.
- To establish IFN-alpha as a standard systemic therapy for MRCC.
Main Methods:
- Review of Phase III studies and clinical data on IFN-alpha therapy for MRCC.
- Analysis of response rates, duration, survival benefits, and side effects.
- Comparison of IFN-alpha monotherapy with combination treatments.
Main Results:
- IFN-alpha yields a 15% response rate in MRCC, with rare complete responses.
- Survival gain with IFN-alpha is modest (3-7 months) compared to placebo.
- Flu-like symptoms are common and can be dose-limiting; combination therapies are not superior to monotherapy.
Conclusions:
- IFN-alpha is the standard systemic treatment for eligible MRCC patients.
- Predictive factors for positive outcomes include good performance status and longer intervals since diagnosis.
- IFN-gamma is not recommended; IFN-beta and natural IFN show similar efficacy to IFN-alpha.