title: Effects of 13-cis-retinoic acid on chemoimmunotherapy of metastatic renal cell carcinoma--results of a retrospective analysis.
abstract: Chemoimmunotherapy (CIT) with interleukin-2, interferon-alpha2a, and 5-fluorouracil is an accepted treatment option of metastatic renal cell carcinoma (mRCC). Because of the enhancement of the antiproliferative effects of interferon-alpha2a, 13-cis-retinoic acid (13-CRA) might be of potential usefulness for immunotherapy. We have investigated the effect of 13-CRA in patients treated with chemoimmunotherapy. Seventy-two patients with mRCC and a Karnofsky performance index > or = 80% were retrospectively analyzed. Thirty-six patients received chemoimmunotherapy and 36 other patients were treated similarly but with addition of daily 60 mg 13-CRA. Response was assessed according to the UICC criteria. Survival was calculated by Kaplan Meier estimation and compared with the log-rank test. In the CIT group objective remissions occurred in 34.3% (95% CI 19.1-52.2) and stabilizations in 42.9% (median follow-up 16 months). In the CIT plus 13-CRA group, objective remissions were seen in 26.4% (95% CI 12.9-44.4) and stabilizations in 50% (median follow-up 17 months). One- and three-year survival rates were 76% and 32% in the CIT group and 82% and 37% in the CIT plus 13-CRA group. The combination of CIT and 13-CRA did not significantly differ in objective remissions and estimated survival compared with CIT. Our retrospective data suggest that 13-CRA does not enhance the therapeutic efficacy of CIT in mRCC patients with a good performance status.
authors.affiliation: Department of Urology, University Hospital Charité, Medical Faculty of the Humboldt University of Berlin, Germany. jan.roigas@charite.de
authors.forename: Jan
authors.initials: J
authors.lastname: Roigas
authors.forename: Serdar
authors.initials: S
authors.lastname: Deger
authors.forename: Kasra
authors.initials: K
authors.lastname: Taymoorian
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Wille
authors.forename: Manfred
authors.initials: M
authors.lastname: Johannsen
authors.forename: Ingolf
authors.initials: I
authors.lastname: Türk
authors.forename: Dietmar
authors.initials: D
authors.lastname: Schnorr
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Loening
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D002455:Cell Division / Q000187:drug effects; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D007376:Interleukin-2 / Q000008:administration & dosage; D015474:Isotretinoin / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D007376:Interleukin-2; D011994:Recombinant Proteins; D015474:Isotretinoin; D005472:Fluorouracil