Treatment of metastatic renal cell carcinoma with activated autologous macrophages and granulocyte-macrophage colony-stimulating factor

Fifteen patients with progressive metastatic renal cell carcinoma were trea ted with granulocyte-macrophage colony-stimulating factor and intravenous i nfusions of activated autologous macrophages (AAMs). The latter were prepar ed from leukapheresis-separated mononuclear cells cultured in the presence of granulocyte-macrophage colony-stimulating factor, exposed to gamma inter feron, and submitted to elutriation to separate AAMs. Three intravenous inj ections of AAMs were performed within a 2-week interval. This treatment cyc le was repeated once or twice, in cases of tumor response or stabilization. Ninety-seven preparations containing a mean 3 x 10(9) AAMs were administer ed and usually well tolerated. One partial response, eight stabilizations a nd six progressions were observed. The median time to progression and media n overall survival time after inclusion were 7 and 9 months, respectively. The cells injected did not accumulate substantially in tumor lesions, as sh own by scintigraphic imaging of indium-111-labeled AAMs. Thus, combined gra nulocyte-macrophage colony-stimulating factor and AAM treatment was well to lerated and resulted in transitory stabilization (n = 8) or partial regress ion (n = 1) in 9 of 15 patients.