Treatment of kidney cancer with autologous tumor cell vaccines of short-term cell lines derived from renal cell carcinoma

Background. We established short-term cultures of autologous tumors from pa tients with renal carcinoma for use as active specific immunotherapy (i.e., autologous vaccine). Methods, Between 9/91 and 9/99 the cell biology laboratory of the Hoag Canc er Center received 69 kidney tumor samples that had been surgically excised , including 43 primary tumors and 26 metastatic lesions. Efforts were made to establish short-term tumor cell cultures to use as autologous tumor cell vaccines. Prior to treatment patients underwent a baseline skin test for d elayed tumor hypersensitivity (DTH) and then received s.c, injections of 10 million irradiated tumor cells that were given with various adjuvants week ly x 3 and then monthly x 5. Results. Cell lines were established for 55/69 patients (80%) including 36/ 43 (84%) from primary tumors and 19/26 (73%) from distant metastases. Vacci nes were prepared for 41 patients; 27 were treated At the time of this anal ysis, follow up data was available for 26 patients with a median follow up > 5 years. Treatment was well-tolerated Of 10 patients who had no evident d isease at the time of treatment, nine were alive 1-8 years later; 5/8 had c onversion of their DTH test from negative to positive. For 16 patients with measurable metastatic disease at the time of treatment, there were no obje ctive tumor responses; their median survival was 5.0 months. Among these 16 patients, only 1/8 DTH tests converted, but three had a positive baseline DTH test; one was previously treated with interleukin-2 and tumor infiltrat ing lymphocytes and two others were previously treated with autolymphocyte therapy. Conclusions. Vaccine therapy with short-term cultures of autologous tumor c ells is feasible, weld-tolerated and associated with conversion of DTH and long-term survival in patients who are free of disease at the time treatmen t is initiated However, significant anti-tumor responses were not seen in p atients with mensurable disease at the time vaccine treatment was initiated .