[Immunotherapy of renal cell carcinoma: results from current phase-III-trials]

Renal cell cancer is still a challenge not only concerning operative techniques (nephron-sparing techniques, established minimally-invasive techniques, such as laparoscopy, and experimental minimally-invasive techniques, such as cryoablation, radiofrequency ablation and others), but also with regard to the impact of systemic (immuno)therapy. Today, a therapeutic algorithm according to tumor stage can be set up as follows: tumors smaller than 4 cm in diameter (T1a, TNM classification 2003) result in disease-free survival of more than 90%. One of the main questions is whether to apply elective nephron-sparing techniques. Organ-confined tumors larger than 4 cm (T1b and T2, TNM classification 2003) have a significant risk like locally advanced tumors (T3, TNM classification 2003) and represent a challenge for adjuvant strategies ("surgical therapy plus X"). Primary metastasized kidney cancer are to be treated with "surgical cytoreduction plus X" and secondary (metachronous) metastasized tumors confront established and new systemic (immuno)therapy. This review presents the results from current phase-III-trials investigating immunotherapy for renal carcinoma.