ADJUVANT IMMUNOTHERAPY WITH KEYHOLE LIMPE T HEMOCYANIN (KLH) IN RENAL-CELL CARCINOMA FOR CATEGORY PT 2 N-4, NO-N+, MO( AND PT 3)

This study was a prospective randomized trial to compare adjuvant immu notherapy with Keyhole Limpet Hemocyanin (KLH) after radical nephrecto my. From January 1983 to December 1988, 50 patients underwent radical nephrectomy for category PT 2 N+ and PT 3-4, No-N+, Mo renal cell carc inoma. Postoperatively 25 patients were given adjuvant treatment with the biological response modifier, Keyhole Limpet Hemocyanin (KLH), and 25 patients were in the control group. In each group 2 patients were lost to follow-up. The mean follow-up time was 55 months. Adjuvant tre atment with KLH did not appear to improve the prognosis in renal cell carcinoma patients. The 5-year survival rate was 60% in the KLH group and 56.5% in the control group. Progress was seen in 9/23 in the KLH g roup, 10/23 in the controls. The median survival in patients showing p rogress was 27 and 28 months in the two groups, respectively. Studies with a combination of low dose cyclophosphamide and KLH revealed a pos itive immunostimulating effect, which may provide the rationale for fu rther research concerning different KLH doses, schedules or therapeuti c combinations.