[Immunotherapy for advanced renal cell carcinoma]

Significant advances have been achieved in the surgical treatment of localized renal cell carcinoma over recent years. However, despite significant research efforts, the prognosis is still dismal in the majority of patients with advanced disease. Treatment with IFN-ac leads to moderately increased survival. In addition, survival can be prolonged by tu-mor nephrectomy in patients with synchronous metastases. Combined treatment with IFN-a, IL-2 and 5-FU has demonstrated a survival benefit in a single randomized controlled trial. High dose IL-2 causes long-term regression in a small fraction of patients. All of these treatments, however, frequently cause significant morbidity and therefore the potential benefit has to be weighed carefully against toxicity in each individual patient. Although, in general, the results of immunotherapeutic approaches have been dis-appointing, studies using allogeneic stem cells, allogeneic mononuclear cells and vaccines clearly demonstrate, that tumor control can be achieved by means of immunological intervention. Future research will hopefully lead to the development of strategies helpful for a greater proportion of patients with this disease.