Immunotherapy of metastatic renal cell cancer.
BACKGROUND
The management of metastatic renal cancer remains a therapeutic challenge. Conventional cytotoxic chemotherapy is rarely effective, and the most promising approaches appear to lie in the field of immunotherapy.


METHODS
The authors review the literature regarding current and investigational immunotherapy approaches to the management of metastatic renal cancer.


RESULTS
The mechanism of action, methods of delivery, efficacy, and side effect profile of the cytokines IL-2 and interferon alfa are discussed. The role of investigational approaches such as tumor vaccines, antibody-based therapy, lymphocyte infusions, and bone marrow transplantation is addressed. The rationale for nephrectomy as an adjunctive procedure to immunotherapy is also discussed.


CONCLUSIONS
Ongoing laboratory investigation of the cause of the immune deficit in patients with metastatic renal cell cancer will result in the development of novel therapies to enhance tumor cell recognition as well as host antitumor response. Translation of laboratory findings into the clinic will be facilitated by the presence of an already well-developed infrastructure for the performance of clinical trials for patients with this difficult diagnosis.
Fishman
Mayer
M
Genitourinary Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Seigne
John
J
D000970:Antineoplastic Agents / Q000627:therapeutic use; D019496:Cancer Vaccines / Q000276:immunology / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000276:immunology / Q000556:secondary / Q000628:therapy*; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000639:trends; D016898:Interferon-alpha / Q000627:therapeutic use; D007376:Interleukin-2 / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D009392:Nephrectomy
D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D016898:Interferon-alpha; D007376:Interleukin-2