Factors Modulating Responses to Immunochemotherapy in Advanced Renal Cell Carcinomas

Song, Che Ryn; Ahn, Han Jong; Kim, Choung Soo

Abstract

PURPOSE: Despite numerous trials no various immunochemotherapeutic agents, advanced renal cell carcinomas (RCC) remain highly resistant to treatment. We report the results of immunochemotherapy to evaluate its efficacy, and to investigate factors modulating responses to treatment.
MATERIALS AND METHODS
In this retrospective analysis, 54 patients with advanced RCC, having received either interferon-alpha (IFN-alpha) monotherapy, or a combination of interleukin-2 (IL-2), 5-fluorouracil (5-FU) and vinblastine, with IFN-alpha between January 1999 and March 2001, were reviewed. The patients were divided into 2 groups, either single or combined, therapy groups, which were further subdivided into locally advanced and metastatic disease groups. The nephrectomy and performance stati, cancer stage at the beginning of the immunotherapy, metastasized organs and interval to metastasis, were considered, and the responses to treatment and survival were evaluated accordingly in each subgroup.
RESULTS
Of the 54 patients, 39 received monotherapy, 34 of which had a metastatic disease. Partial remission was observed in 1 patient (2.9%) with a duration of response of 52 weeks, a median survival of 47 weeks (4-323 wks) and a 1 year survival rate of 41.2%. Of the 15 patients in the combined therapy group, 12 with a metastatic disease, complete remission was noted in 1 patient (8.3%), with a continuous response at 57 weeks, a median survival of 34 weeks (4-204 wks) and a 1 year survival rate 41.7%. Of the prognostic factors, the nephrectomy status proved to be the only significant factor improving survival.
CONCLUSIONS
Advanced RCC exhibited a very limited response, and nephrectomy status was revealed to be the only significant factor affecting survival. The efficacy of immunotherapy on locally advanced RCC needs further controlled evaluative studies.