Klin Onkol 1997; 10(2): 37-42.
The most efficient therapy in renal cell cancer is surgery. Renal cell cancer is a relatively radioresistent tumor and radiotherapy is used to control bleeding and pain from the primary advanced inoperable tumor and to palliate symptoms from metastases to the CNS and bone. Chemotherapy has low efficacy. The response rates after various chemotherapy regimens was no higher than 10%. The most effective chemotherapy is considered to be a weekly application of vinblastine. The combination with chemotherapy has no higher response rates, but it is more toxic. Hormonotherapy brings no response. Many studies with interferon alpha monotherapy of kidney cancer were published. The interferon monotherapy has the response rate of about 15-20%. The combination of interferon alpha and vinblastine was claimed in one study to bring a islightly higher response rate than interferon alpha alone. The prognostic criteria for good response to interferon alpha are: resected primary kidney tumor and the presence of only lung metastases.
There have been many papers published in the last years describing the effect of Interleukin-2 monotherapy or its combination therapy with interferon alpha. Interleukin-2 achieves about a 20% response rate in monotherapy, and the combination with interferon alpha has even higher response rates, 20-25%. Combined therapy, interferon alpha and interleukin-2, is very toxic, but it seems to be a new possibility how to get durable responses in appropriate patients with metastatic renal cell carcinoma.
