A medical oncologist's approach to immunotherapy for advanced renal tumors: is nephrectomy indicated?
Metastatic renal cell carcinoma is highly resistant to systemic therapy. Although interleukin-2 and interferon remain the most active agents for this disease, long-term survival rates remain poor. Two phase 3 trials, European Organization Research and Treatment of Cancer 30947 and Southwest Oncology Group 8949, have demonstrated a survival benefit of nephrectomy followed by interferon versus interferon alone in patients having an excellent performance status (PS 0 and 1). Removal of the primary tumor followed by interferon is not recommended for patients with a moderate or poor PS (PS 2-4). Even with this aggressive approach, most patients eventually will die from their kidney cancer; therefore, every patient with metastatic disease should be considered for enrollment into clinical trials.
Cooney
Matthew M
MM
Division of Hematology/Oncology, University Hospitals of Cleveland, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA. matthewcooney@yahoo.com
Remick
Scot C
SC
Vogelzang
Nicholas J
NJ
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy; D007372:Interferons / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D008495:Medical Oncology; D009392:Nephrectomy
D000970:Antineoplastic Agents; D007372:Interferons