Chemoimmunotherapy in the systemic treatment of advanced renal carcinoma

Polychemotherapy and immunomodulating treatment using IL-2 and/or IFN-alpha produce objective responses in a proportion of advanced renal cell carcino ma patients. The goals of an improved cost effectiveness and therapeutic in dex of interleukin-2 and/or Interferon-cr in combination with chemotherapeu tic agents require the design of risk factor adapted individual therapeutic strategies for the outpatient setting. High dose i.v. IL-2 therapy in meta static renal cell carcinoma has been proven effective [11]. Other modalitie s of applying IL-2 have been described [12-14] (Table 1). A cumulative risk -score identified three risk-groups with significant differences in median survival [16]. The SC use of IL-2 and INF-alpha has been established in the treatment of RCC [16, 23]. It appears that combination chemoimmunotherapy including p.o, retinoic acid is far more effective than single agent treatm ent. Further studies will have to be designed to improve therapeutic index and cost effectiveness in systemic combination therapy in metastatic RCC.