Alpha-interferon 2a and 1 3-cis-retinoic acid for the treatment of metastatic renal cell carcinoma.
BACKGROUND
It is suggested that immunotherapy may have a better role than cytotoxic chemotherapy in the treatment of metastatic renal cell carcinoma.


OBJECTIVE
A phase II study of alpha-interferon 2a (IFN2a) and 13-cis-retinoic acid (CRA) in the treatment of metastatic renal cell carcinoma.


METHODS
Twenty-two patients with no previous systemic therapy were treated with IFN2a daily at 3 million units (MU) and escalated to 6 and 9 MU if tolerated, together with CRA given orally at 1 mg/kg per day in two divided doses. Changes in quality of life were also assessed.


RESULTS
Twenty patients were available for assessment. Three patients (14%) achieved a partial response and five patients (23%) had stable disease. No patient achieved a complete response. A durable response was observed in partial responders with median length of response of 44 weeks (range 32-59 weeks). Therapy was stopped in seven (35%) patients due to treatment-related toxicities, and quality of life was worsened in the majority of patients.


CONCLUSIONS
IFN2a and CRA has a low response rate and significant toxicity, and the combination as standard treatment of metastatic renal cell carcinoma is not recommended, despite the suggestion that CRA may lengthen the response to IFN2a.
Wong
M
M
Department of Medical Oncology, Westmead Hospital, Sydney, New South Wales, Australia. markwong@westgate.wh.usyd.edu.au
Goldstein
D
D
Woo
H
H
Testa
G
G
Gurney
H
H
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D015474:Isotretinoin / Q000008:administration & dosage*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D011994:Recombinant Proteins; D015996:Survival Rate; D016896:Treatment Outcome
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D015474:Isotretinoin