INTERFERON-ALPHA AND SURVIVAL IN RENAL-CELL CANCER

Objective To establish whether the use of interferon-alpha might resul t in improved survival, using two large series of patients with advanc ed renal cell cancer treated during studies of chemotherapy and biolog ical therapy, respectively. Patients and methods Patients treated eith er in the Eastern Cooperative Oncology Group (ECOG) chemotherapy proto cols (327 patients) or in protocols employing interferon as part of a European randomized study or phase II studies at the Norwegian Radium Hospital (231 patients) were retrospectively analysed. Groups for comp arison were matched by exclusion of those with an ECOG performance sta tus >2, no prior nephrectomy, brain metastases or prior chemotherapy. Univariate analysis of prognostic factors for survival was performed b y the log rank method and multivariate analysis by Cox regression. Res ults Univariate analysis of the whole population showed that performan ce status, time from diagnosisto treatment, sites of metastases and th e use of interferon carried the greatest prognostic significance. In m ultivariate analysis, the use of interferon remained a significant pre dictor of survival (P<0.001). Subgroup analysis suggested that the imp act of interferon treatment was greatest in those patients with two of the following characteristics; good performance status, an interval o f >2 years from diagnosis to treatment and no more than one site of me tastasis. Conclusion Although a prospective randomized trial is needed to establish definite benefit from the use of interferon in advanced renal cell cancer, this analysis supports the rationale for performing such a trial, particularly in patients with relatively good prognosti c features. Patients should be entered into the Medical Research Counc il study comparing interferon with medroxyprogesterone acetate.