Immunotherapy of renal cell cancer

Immunotherapy of metastatic renal adenocarcinoma (RCC) is currently an alternative to cytotoxic chemotherapy. Bacillus Calmette-Guérin has been associated with a 22% response rate in small series, but no large-scale clinical trials have been completed. Transfer factor, in combination with other immunotherapeutic and chemotherapeutic compounds, has a reported 13% incidence of response. Tumor vaccines have caused clinical response in only 5% of patients while monoclonal antibodies have produced partial remission in one of nine patients. Immune RNA has been associated with a 14% overall incidence of response. Tumor necrosis factor has not as yet been studied in any large-scale clinical investigations but preliminary studies are not promising. Leukocyte-derived and recombinant interferons alone have produced responses in 10-20% of patients with tolerable toxicity. Combinations of interferons or with cytotoxic chemotherapy have produced slightly improved responses with short duration and substantial toxicity. Adoptive immunotherapy using Interleukin-2 alone, or with IL-2 plus lymphocyte-activated killer cells, or tumor infiltrating lymphocytes or interferons have produced clinical responses in 10-30% of patients treated. Combinations of specific forms of immune therapy may hold promise for better rates of clinical response in the future.