[Renal cancer :therapeutical dilemma]

Renal cell carcinoma constitutes 3% of all adult malignancies. Surgical resection remains the cornerstone of management for localised renal cell carcinoma. No effective postsurgical adjuvant therapy has been established for patients with locally advanced disease who are a high risk for recurrence. The effective treatment of metastatic kidney cancer remains a challenge. Despite extensive investigations with different treatment modalities, metastatic renal cell carcinoma remains high resistant to systemic therapy. Combination chemotherapy alone or in combination with cytokine, is a very little use. Small numbers of patients' exhibits complete or partial responses to interferon and/or interleukin-2, but most patients do not respond and few survive over the long term. New immunologic approaches to the treatment of both advanced and high-risk postsurgical disease are focusing on novel vaccine therapies to target both renal epithelial and vascular antigens.