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J Urol. 1999 Feb;161(2):381-6; discussion 386-7.

Renal cell carcinoma: management of advanced disease.

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1
Division of Hematology-Oncology, UCLA School of Medicine, Jonsson Comprehensive Cancer Center, Los Angeles, California, USA.

Abstract

PURPOSE:

We provide a current review of the management of advanced renal cell carcinoma.

MATERIALS AND METHODS:

A comprehensive literature review of peer reviewed articles which address the current management of metastatic renal cell carcinoma was performed.

RESULTS:

Renal cell carcinoma is the seventh leading cause of cancer, accounting for 3% of malignancies in men. The incidence of renal cell carcinoma has increased significantly by 38% from 1974 through 1990 at least in part related to earlier diagnosis with the common use of new radiological techniques. Cytotoxic chemotherapy remains poor as a treatment alternative. Interferon-alpha produces responses in 15 to 20% of patients but clinical usefulness as monotherapy has been surpassed by interleukin-2 (IL-2). IL-2 is the first immunotherapy to produce durable remissions resulting in approval by the Food and Drug Administration. Although high dose bolus IL-2 schedules have the longest followup, IL-2 administered on other schedules may have enhanced efficacy. Randomized trials are attempting to delineate the appropriate role for various doses and schedules.

CONCLUSIONS:

Advanced renal cell carcinoma, once a disease relegated to the incurable, during the last decade has evolved into a malignancy that may be associated with cure. The first evidence of this potential is the clear and unequivocal demonstration that IL-2 produces durable complete remissions. Building upon this immunotherapeutic approach the future treatment of renal cell carcinoma will incorporate new immunological technology, including gene, dendritic cell, vaccine and antibody therapy.

PMID:
9915408
DOI:
10.1016/s0022-5347(01)61897-4
[Indexed for MEDLINE]

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