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Immunotherapy for metastatic renal cell carcinoma
1Department of Urology, Medical School, Dresden, Germany.
Abstract:
Immunotherapy with autologous tumor cells, tumor cell vaccines, and immune RNA did not become established in the treatment of renal cell carcinoma, as the response rates were low, and in some investigations, no response at all could be detected. In the past, cytokines such as interferons, IL-2, and TNF have been tested on a large scale in the treatment of advanced renal cell carcinoma. However, the rates of objective remission (partial and complete) are disappointing, only rarely exceeding 20%. Up to now, longer survival could not be demonstrated in patients with advanced renal cell carcinoma after treatment with cytokines. The combination of IFN-alpha and IL-2 by subcutaneous administration appears to provide results similar to those of other treatment modalities with lower morbidity. However, because generally accepted treatment schedules for cytokine therapy do not exist, and because the patients who would profit most from treatment with cytokines cannot be exactly defined, the administration of these agents is indicated at present only in the context of prospective clinical trials.
Insights
Previous immunotherapies for renal cell carcinoma showed low response rates. Cytokine therapies, including interferon-alpha and IL-2, offer limited remission and survival benefits, warranting further clinical trials.
Area of Science:
- Oncology
- Immunology
Background:
- Autologous tumor cell, tumor cell vaccine, and immune RNA immunotherapies for renal cell carcinoma (RCC) showed limited efficacy.
- Cytokine therapies, including interferons (IFN), interleukin-2 (IL-2), and tumor necrosis factor (TNF), have been widely investigated for advanced RCC.
Purpose of the Study:
- To evaluate the efficacy and safety of cytokine-based immunotherapies for advanced renal cell carcinoma.
- To assess the potential of combined interferon-alpha and IL-2 therapy in RCC treatment.
Main Methods:
- Review of previous studies on immunotherapy and cytokine therapy for renal cell carcinoma.
- Analysis of objective remission rates and survival data from patients treated with cytokines.
Main Results:
- Immunotherapies demonstrated low response rates in renal cell carcinoma treatment.
- Cytokine therapies, including IFN and IL-2, rarely achieved objective remission rates exceeding 20% and did not significantly improve survival.
- Subcutaneous administration of IFN-alpha and IL-2 showed comparable results to other modalities with reduced morbidity.
Conclusions:
- Current cytokine therapies for advanced renal cell carcinoma offer limited clinical benefit.
- Lack of established treatment schedules and defined patient populations for cytokine therapy necessitates its use within prospective clinical trials.