title: Implications of therapy choice on overall survival in metastatic renal cell carcinoma: a single institution experience.
abstract: OBJECTIVE
  To compare the effect of high-dose interleukin-2 (HD IL-2) vs other cytokine therapies on 1-, 2, and 5-yr overall survival in patients with metastatic renal cell cancer (RCC).
  
  
  METHODS
  We conducted a retrospective chart review of patients with untreated metastatic RCC treated by a single investigator. The different treatment groups included HD IL-2, low-dose IL-2 alone or in combination, interferon alpha alone and other therapies. The primary end point was survival from time of treatment.
  
  
  RESULTS
  A total of 85 patients were studies with a median follow up of 13 mo (0.6-112.9). Median age at treatment was 59 yr with predominantly male patients and histology of clear cell type. Thirty-four percent received HD IL-2 and treatment was initiated less than 6 mo from the time of diagnosis in 66%. For all patients, median survival was 16 mo with a 5-yr survival of 12%. Two factors were good predictors of overall survival: Karnofsky performance status (KPS) of 100 (p < 0.0001) and soft tissue metastasis (p = 0.01). When comparing HD IL-2 to all other groups, median survival was 18 vs 14 mo and 1-yr survival was 74% vs 51%, respectively.
  
  
  CONCLUSIONS
  HD IL-2 is associated with clinically meaningful improvement in median and 1-yr survival.
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine and The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.
authors.forename: Simrit
authors.initials: S
authors.lastname: Parmar
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Rademaker
authors.forename: Bing B
authors.initials: BB
authors.lastname: Fung
authors.forename: James M
authors.initials: JM
authors.lastname: Kozlowski
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Kuzel
mesh_terms: D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality*; D016207:Cytokines / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D016207:Cytokines; D007376:Interleukin-2