[Tumor cell vaccination for treatment of renal cell carcinoma]

Vaccination, mostly with inactivated autologous tumour, has been carried out for the treatment of renal cell cancer since 1976. Attempts to enhance immunogenicity have involved the use of different modifications and added adjuvants for preparation of the vaccines. In metastatic renal cell cancer vaccination has proved to be ineffective, apart from remissions observed in isolated cases. In principle, however, it does seem that vaccination might be valuable as an adjuvant treatment for renal cell cancer. Following resection of the primary tumour, the blood and lymphatic system should be sterilized by cytotoxic T cells and antitumour antibodies induced by vaccination. The effectiveness of such therapeutic procedures cannot be proven except in prospective randomized trials with untreated patients as controls. Clinical trials of autologous tumour vaccines modified by bacillus Calmette Guérin have failed to demonstrate increased disease-free survival. New prospects for future vaccine preparations are opened up by the recent detection of MHC-restricted tumour-specific T cells and by the possibility of genetically modified vaccines.