The use of interferon in renal cell carcinoma

Metastatic renal cell carcinoma remains an incurable disease and current modalities can only offer major palliation to a small percentage of patients. Since treatment is palliative, choice and type of therapy must be carefully considered and reconciled with patient desires. When possible, patients should be offered participation in a clinical trial. For patients choosing progestin therapy, treatment with interferon (IFN) or other biological response modifiers can be instituted at the time of progestin failure. Those patients who have slow tumour progression and maintain a high quality of life can be observed without continued progestin therapy. Although pretreatment characteristics predict response to biologicals, no pretreatment characteristic should preclude an individual patient from a trial of IFN therapy. Whether high-dose interleukin-2 (IL-2), IL-2/lymphocyte-activated killer cells, or IL-2/IFN are superior to IFN alone is uncertain, but clinical trials currently underway should help resolve these issues.