Systemic therapy for renal cell carcinoma Journal Article
| Authors: | Motzer, R. J.; Russo, P. |
| Article Title: | Systemic therapy for renal cell carcinoma |
| Abstract: | Purpose: We review the status of systemic therapy for patients with advanced renal cell carcinoma. Materials and Methods: A literature search was performed on MEDLINE and CANCERLIT to identify results of systemic therapy for patients with renal cell carcinoma published from January 1990 through December 1998. Treatment results of chemotherapy agents, immunotherapy, combination programs and adjuvant therapy were reviewed. Results: No chemotherapy agent has produced response rates that justify its use as a single agent. Interferon-α and interleukin (IL)-2 demonstrated low response rates ranging from 10% to 20%. The results of 2 randomized trials suggest that treatment with interferon-α compared to vinblastine or medroxyprogesterone achieves a small improvement in survival. Response rates in patients treated with low dose IL-2 are similar to those achieved with a high dose bolus schedule but whether the responses are as durable is being addressed in an ongoing randomized trial. A randomized trial of interferon-α plus IL-2 compared to monotherapy with either agent showed increased toxicity but no improvement in survival. In 3 randomized trials no survival benefit was associated with adjuvant interferon-α therapy following complete resection of locally advanced renal cell carcinoma. Conclusions: Despite extensive evaluation of many different treatment modalities, metastatic renal cell carcinoma remains highly resistant to systemic therapy. A few patients exhibit complete or partial responses to interferon and/or IL-2 but most do not respond, and there are few long-term survivors. Preclinical research, and clinical evaluation of new agents and treatment programs to identify improved antitumor activity against metastases remain the highest priorities in this refractory disease. |
| Keywords: | cancer survival; treatment outcome; cancer surgery; review; doxorubicin; fluorouracil; cancer combination chemotherapy; gemcitabine; paclitaxel; cancer adjuvant therapy; combined modality therapy; interleukin 2; unindexed drug; cancer immunotherapy; granulocyte macrophage colony stimulating factor; interleukin 4; kidney carcinoma; kidney neoplasms; nephrectomy; vinblastine; irinotecan; survival time; medical information; gamma interferon; carcinoma, renal cell; medical record; data analysis; carcinoma; interleukin 6; tamoxifen; drug therapy; cyclosporin a; floxuridine; interleukin 12; suramin; interleukins; medroxyprogesterone acetate; toremifene; lonidamine; interleukin 1; renal cell; cimetidine; levamisole; dipyridamole; merbarone; quinidine; valspodar; mafosfamide; interferons; humans; human; priority journal; acrivastine; roquinimex |
| Journal Title: | Journal of Urology |
| Volume: | 163 |
| Issue: | 2 |
| ISSN: | 0022-5347 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2000-02-01 |
| Start Page: | 408 |
| End Page: | 417 |
| Language: | English |
| PUBMED: | 10647643 |
| PROVIDER: | scopus |
| DOI: | 10.1016/S0022-5347(05)67889-5 |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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