Immunotherapy in renal cell carcinoma

Patients with metastatic renal cell carcinoma continue to present a therape utic challenge. Current therapeutic approaches involve surgery and various types of immunotherapy, The rationale for this latter form of therapy inclu de the observations of spontaneous tumor regression, the presence of a T-ce ll-mediated immune response, and the tumor responses observed in patients r eceiving cytokine therapy, Analysis of prognostic factors in these patients demonstrates that clinical responses occur most frequently in individuals with good performance status. The cytokines interleukin-2 (IL-2, aldesleuki n [Proleukin], interferon-alfa (Intron A, Roferon-A), or the combination pr oduce responses in 15% to 20% of patients. Randomized trials suggest that a dministration of interferon-alfa may result in a modest improvement in medi an survival, Investigation of the molecular genetics of renal cell carcinom a and the presence of T-lymphocyte immune dysregulation have suggested new therapeutic strategies. Further preclinical and clinical studies investigat ing inhibitors of angiogenesis or pharmacologic methods to reverse immune d ysregulation are ongoing. Therapeutic results in patients with renal cell c arcinoma remain limited, and investigational approaches ave warranted.