The immunotherapy and cellular biology of renal cell carcinoma

It is clear from the work presented at this symposium that immunotherapy has joined surgery, chemotherapy, and radiation as the next generation of treatment for at least some human malignancies. Several problems remain to be addressed before the use of immunotherapy is optimized, including: (1) understanding the genetic and cellular growth control mechanisms gone awry in the development and progression of RCC; (2) defining the mechanisms by which antitumor lymphocytes are cytotoxic; (3) establishing an inexpensive and less labor-intensive way of identifying and isolating the most active antitumor lymphocytes from LAK cells and TILs; (4) designing methods to optimize delivery of effector cells to tumor beds; and (5) exploiting combinations of immune effectors and other therapies for improved killing of cells and lower toxicity. Answers to these problems will no doubt form the basis for future symposia.