Systemic chemotherapy and chemoimmunotherapy for metastatic renal cell cancer

We review the current literature on systemic therapy for patients with meta static renal cell carcinoma. Metastatic renal cell carcinoma remains highly resistant to chemotherapy and hormonal agents not justifying its use as a single agent. Interleukin-2 immunotherapy is the most effective treatment f or metastatic renal cell carcinoma available today. There is evidence that interleukin-2 improves survival and yields longlasting remissions in select ed patients the optimal dose and schedule still need to be defined. Respons e rates in patients treated with subcutaneous interleukin-2 are similar to those achieved with high-dose bolus intravenous applications. Questions rem ain concerning quality of life and benefit-to-risk ratio with respect to im munotherapy in individual patients. Different routes of administration of i nterleukin-2 such as local application, promise to improve quality of life and survival times.