Skip to main content
Log in

Immunotherapy in metastatic renal cell carcinoma

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Metastatic renal cell carcinoma has a poor prognosis. Conventional therapies such as chemotherapy, radiation or hormonal treatment have hardly any effect on the progression of this disease. As renal cell carcinoma seems to be an immunogenic tumor, several immunotherapeutic approaches with different response rates have been developed since the early 1990s. We present an overview of various immunotherapeutic approaches such as cytokine-based regimes, with and without different cytotoxic chemotherapy, of metastatic renal cell carcinoma. In addition, local therapies (e.g. inhalation of interleukin-2) are reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ljungberg B (2004) Prognostic factors in renal cell carcinoma. Urologe A. 43 [Suppl 3]:119–120

  2. Pisani P, Parkin DM, Ferlay J (1993) Estimates of the worldwide mortality from eighteen major cancers in 1985: implications for prevention and projections of future burden. Int J Cancer 55:891

    Google Scholar 

  3. Landis SH, Murray T, Bolden S, Wingo PA (1998) Cancer statistics, 1998. Cancer J Clin 48:6–29

    CAS  PubMed  Google Scholar 

  4. Pantuck AJ, Zisman A, Belldegrun AS (2001) The changing natural history of renal cell carcinoma. J Urol 166:1611–1623

    Google Scholar 

  5. De Kernion JB, Ramming KP, Smith RB (1978) The natural history of metastatic renal cell carcinoma: a computer analysis. J Urol 120:148–52

    CAS  PubMed  Google Scholar 

  6. Lam JS, Shvarts O, Figlin RA, Belldegrun AS (2004) Renal cell carcinoma 2004: new frontiers in staging, prognostication, and targeted molecular therapy. J Urol (in press)

    Google Scholar 

  7. Bukowski RM (1997) Natural history and therapy of metastatic renal cell carcinoma: the role of interleukin-2. Cancer 80:1198–1220

    Article  Google Scholar 

  8. Figlin RA (1999) Renal cell carcinoma: management of advanced disease. J Urol 161:381–387

    Article  Google Scholar 

  9. Young RC (1998) Metastatic renal-cell carcinoma: what causes occasional dramatic regressions? New Engl J Med 338:1305–1306

    Google Scholar 

  10. Siebels M, Theodorakis J, Liedl B, Schneede P, Hofstetter A (2000) Large de novo renal cell carcinoma in a 10-year-old transplanted kidney: successful organ-preserving therapy. Transplantation 69:677–679

    Article  CAS  PubMed  Google Scholar 

  11. Feldmann JD, Jacobs SC (1992) Late development of renal carcinoma in allograft kidney. J Urol 148:395–397

    CAS  PubMed  Google Scholar 

  12. Williams JC, Merguerian PA, Schned AR, Morrison PM (1995) Acquired renal cystic disease and renal cell carcinoma in an allograft kidney. J Urol 152:395–396

    Google Scholar 

  13. Wyczolkowski M, Klima W, Bieda W, Walas K (2001) Spontaneous regression of hepatic metastases after nephrectomy and metastasectomy of renal cell carcinoma. Urol Int 66:119–120

    Google Scholar 

  14. Amato RJ (2000) Chemotherapy for renal cell carcinoma. Semin Oncol 27:177–186

    Google Scholar 

  15. Mickisch GH, Roehrich K, Koessig J, Forster S, Tschada RK, Alken PM (1990) Mechanisms and modulation of multidrug resistance in primary human renal cell carcinoma. J Urol 144:755–759

    Google Scholar 

  16. Volm M, Kastel M, Mattern J, Efferth T (1993) Expression of resistance factors (P-glycoprotein, glutathione S-transferase-pi, and topoisomerase II) and their interrelationship to proto-oncogene products in renal cell carcinomas. Cancer 71:3981–3987

    Google Scholar 

  17. Nanus DM, Garino A, Milowsky MI, Larkin M, Dutcher J (2004) Active chemotherapy for sarcomatoid and rapidly progressing renal cell carcinoma. Cancer 101:1545–1551

    Google Scholar 

  18. Siebels M, Oberneder R, Buchner A, Zaak D, Mack A, Petrides PE, Hofstetter A, Wowra (2002) Ambulatory radiosurgery in cerebral metastatic renal cell carcinoma. 5-year outcome in 58 patients. Urologe A 41:482–488

    Google Scholar 

  19. Wowra B, Siebels M, Muacevic A, Kreth FW, Mack A, Hofstetter A (2002) Repeated gamma knife surgery for multiple brain metastases from renal cell carcinoma. J Neurosurg 97:785–793

    Google Scholar 

  20. Brinkmann OA, Bruns F, Prott FJ, Hertle L (1998) Possible synergy of radiotherapy and chemo-immunotherapy in metastatic renal cell carcinoma (RCC). Anticancer Res 19:1583–1587

    Google Scholar 

  21. Fisher RI, Rosenberg SA, Sznol M (1997) High dose aldesleukin in renal cell carcinoma: long term survival update. Cancer J Sci Am 3:S70

    Google Scholar 

  22. Kradin R, Kurnick J, Lazarus D, Preffer F, Dubinett S, Pinto C, Gifford J, Davidson E, Grove B, Callahan R, Strauss HW (1989) Tumour-infiltrating lymphocytes and interleukin-2 in treatment of advanced cancer. Lancet: 577

  23. Rosenberg S, Lotze M, Muul L, Chang A, Avis F, Leitman S, Linehan M, Robertson C, Lee R, Rubin J, Seipp C, Simpson C, White D (1987) A progress report on the treatment of 157 patients with advanced cancer using lymphokine-activated killer cells and interleukin-2 or high-dose interleukin-2 alone. New Engl J Med 316:890

    Google Scholar 

  24. Thompson J, Shulman K, Benyunes M, Lindgren C, Collins C, Lange P, Bush W, Benz L, Fefer A (1992) Prolonged continuous intravenous infusion interleukin-2 and lymphokine-activated killer-cell therapy for metastatic renal cell carcinoma. J Clin Oncol 10:960

    Google Scholar 

  25. Figlin RA, Thompson JA, Bukowski RM, Vogelzang NJ, Novick A, Lange P, Steinberg G, Belldegrun AS (1999) Multicenter, randomized, phase III trial of CD8+ tumor-infiltrating lymphocytes in combination with recombinant interleukin-2 in metastatic renal cell carcinoma. J Clin Oncol 17:2521

    Google Scholar 

  26. Heinzer H, Huland E, Huland H (2002) Regional immunotherapy for metastatic renal cell carcinoma. Urologe A 41:239

    Article  CAS  PubMed  Google Scholar 

  27. Huland E, Heinzer H, Timm S, Aalamian M, Huland H (2002) Immuntherapie des metastasierten Nierenzellkarzinoms in Deutschland. Eine Standortbestimmung. Der Urologe A 41:282–287

    Google Scholar 

  28. Huland E, Heinzer H, Huland H (1999) Treatment of pulmonary metastatic renal-cell carcinoma in 116 patients using inhaled interleukin-2 (IL-2). Anticancer Res 19:2679–2683

    CAS  PubMed  Google Scholar 

  29. Rohrmann K, Schleypen J, Adam C, Hofstetter A, Siebels M (2004) Complete remission of pulmonary metastasized renal cell carcinoma after inhalative Interleukin-2 therapy. Urologe A 14:1245–1248

    Google Scholar 

  30. Schleypen JS, Von Geldern M, Weiss EH, Kotzias N, Rohrmann K, Schendel DJ, Falk CS, Pohla H (2003) Renal cell carcinoma-infiltrating natural killer cells express differential repertoires of activating and inhibitory receptors and are inhibited by specific HLA class I allotypes. Int J Cancer 106:905–912

    Article  CAS  PubMed  Google Scholar 

  31. Minasian LM, Motzer RJ, Gluck L, Mazumdar M, Vlamis V, Krown SE (1993) Interferon alfa-2a in advanced renal cell carcinoma: treatment results and survival in 159 patients with long-term follow-up. J Clin Oncol 11:1368

    Google Scholar 

  32. Bleumer I, Oosterwijk E, De Mulder P, Mulders PFA (2003) Immunotherapy for renal cell carcinoma. Eur Urol 44:65–75

    CAS  PubMed  Google Scholar 

  33. Kriegmair M, Oberneder R, Hofstetter A (1995) Interferon alfa and vinblastine versus medroxyprogesterone acetate in the treatment of metastatic renal cell carcinoma. Urology 45:758

    Google Scholar 

  34. Pyrrhonen S, Salminen E, Ruutu M, Lehtonen T, Nurmi M, Tammela T et al. (1999) Prospective randomized trial of interferon alfa-2a plus vinblastine versus vinblastine alone in patients with advanced renal cell cancer. J Clin Oncol 17:2859–2867

    CAS  PubMed  Google Scholar 

  35. Sella A, Logothetis CJ, Fitz K (1992) Phase II study of interferon-alpha and chemotherapy (5-fluorouracil and mitomycin C) in metastatic renal cell cancer. J Urol 147:573

    Google Scholar 

  36. Hänninen EL, Kirchner H, Atzpodien J (1996) Interleukin-2 based home therapy of metastatic renal cell carcinoma, risks and benefits in 215 consecutive single institution patients. J Urol 155:19

    PubMed  Google Scholar 

  37. Hofmockel G, Langer W, Theiss M, Gruss A, Frohmueller HG (1996) Chemoimmunotherapy for metastatic renal cell carcinoma using a regime of interleukin-2, interferon-alpha and 5-fluorouracil. J Urol 156:18

    Article  CAS  PubMed  Google Scholar 

  38. Wadler S, Schwartz EL, Goldman M (1989) Fluorouracil and recombinant alpha-2a-interferon: an active regimen against advanced colorectal carcinoma. J Clin Oncol 7:1769

    Google Scholar 

  39. Wadler S, Schwartz EL (1990) Antineoplastic activity of the combination of interferon and cytotoxic agents against experimental and human malignancies: a review. Cancer Res 50:3473

    Google Scholar 

  40. Wadler S, Wersto R, Weiberg V Thompson D, Schwartz EL (1990) Interaction of fluorouracil and interferon in human colon cancer cell lines: cytotoxic and cytokinetic effects. Cancer Res 50:5735

    Google Scholar 

  41. Negrier S, Caty A, Lesimple T, Douillard J-Y, Escudier B, Rossi J-F, Viens P, Gomez F (2000) Treatment of patients with metastatic renal carcinoma with a combination of subcutaneous interleukin-2 and interferon alfa with or without fluorouracil. J Clin Oncol 18:4009

    CAS  PubMed  Google Scholar 

  42. Negrier S, Escudier B, Lasset C, Douillard J-Y, Savary J, Chevreau C, Ravaud A, Mercatello A, Peny J, Mousseau M, Philip T, Tursz T (1998) Recombinant human interleukin-2, recombinant human interferon alfa-2a, or both in metastatic renal-cell carcinoma. New Engl J Med 338:1272–1278

    Google Scholar 

  43. Atzpodien J, Lopez Hanninen E, Kirchner H, Franzke A, Korfer A, Volkenandt M, Duensing S, Schomburg A, Chaitchik S, Poliwoda H (1995) Chemoimmunotherapy of advanced malignant melanoma: sequential administration of subcutaneous interleukin-2 and interferon-alpha after intravenous dacarbazine and carboplatin or intravenous dacarbazine, cisplatin, carmustine and tamoxifen. Eur J Cancer 31:876–881

    Google Scholar 

  44. Atzpodien J, Kirchner H, Illiger HJ, Metzner B, Ukena D, Schott H, Funke PJ, Gramatzki M, Jurgenson S, Wandert T, Patzelt T, Reitz M (2001) IL-2 in combination with IFN-alpha and 5-FU versus tamoxifen in metastatic renal cell carcinoma: long-term results of a controlled randomized clinical trial. Br J Cancer 85:1130–1136

    Article  CAS  PubMed  Google Scholar 

  45. Sella A, Kilbourn RG, Gray I, Finn L, Zukiwski AA, Ellerhorst J, Amato RJ, Logothetis CJ (1994) Phase I study of interleukin-2 combined with interferon-alpha and 5-fluorouracil in patients with metastatic renal cell cancer. Cancer Biother 9:103–111

    CAS  PubMed  Google Scholar 

  46. Atzpodien J, Kirchner H, Siebels M, Jonas U, Bergmann L, Schott H, Heynemann H, Fornara P, Loening SA, Roigas J, Müller SC, Bodenstein H, Pomer S, Metzner B, Rebmann U, Oberneder R, Wandert T, Patzelt T, Reitz M and DGCIN (2004) Interleukin-2- and Interferon-alpha2a-based Immuno-Chemotherapy in advanced renal cell carcinoma: results of a prospective randomized trial of the German Cooperative Renal Carcinoma Chemoimmunotherapy Group (DGCIN). J Clin Oncol 22:1188–1194

    Article  CAS  PubMed  Google Scholar 

  47. Cassidy J, Dirix L, Bisset D (1998) A phase I study of capecitabine in combination with oral leucovorine in patients with intractable solid tumors. Clin Cancer Res 4:2755

    Google Scholar 

  48. Wenzel C, Locker GJ, Bartsch R, Pluschnig U, Mader R, Hussian D, Kramer G, Marberger M, Lintner C, Rauchenwald M, Zielinski CC, Steger GG (2003) Capecitabine monotherapy and in combination with immunotherapy in the treatment of metastatic renal cell carcinoma. Anticancer Drugs 14:779–784

    Google Scholar 

  49. Stadler WM, Kuzel T, Dumas M, Vogelzang NJ (1998) Multicenter phase II trial of interleukin-2, interferon-alpha, and 13-cis-retinoic acid in patients with metastatic renal cell carcinoma. J Clin Oncol 16:1820

    Google Scholar 

  50. Fossa SD, Mickisch GHJ, De Mulder PHM, Horenblas S, Van Oosterom AT, Van Poppel H, Fey M, Croles JJ, De Prijck L, Van Glabbeke M (2004) Interferon-alpha2a with or without 13-cis retinoic acid in patients with progressive, measurable metastatic renal cell carcinoma. Cancer 101:533–540

    CAS  PubMed  Google Scholar 

  51. Ryan CW, Vogelzang NJ, Dumas M, Kuzel T, Stadler WM (2000) Granulocyte-macrophage-colony stimulating factor in combination immunotherapy for patients with metastatic renal cell carcinoma. Cancer 88:1317

    Google Scholar 

  52. Westermann J, Reich G, Kopp J, Haus U, Dörken B, Pezzutto A (2001) Granulocyte/macrophage-colony-stimulating factor plus interleukin-2 plus interferon-alpha in the treatment of metastatic renal cell carcinoma: a pilot study. Cancer Immunol Immunother 49:613

    Google Scholar 

  53. Van Herpen CM, De Mulder PH (2002) Prognostic and predictive factors of immunotherapy in metastatic renal cell carcinoma. Crit Rev Oncol Hematol 41:327–334

    Google Scholar 

  54. Motzer RJ, Murphy BA, Bacik J, Schwartz LH, Nanus DM, Mariani T et al. (2000) Phase III trial of interferon alfa-2a with or without 13-cis-retinoic acid for patients with advanced renal cell carcinoma. J Clin Oncol 18:2972–2980

    Google Scholar 

  55. Ognibene FP, Rosenberg SA, Lotze M, Skibber J, Parker MM, Shelhamer JH, Parrillo JE (1988) Interleukin-2 administration causes reversible hemodynamicchanges and left ventricular dysfunction similar to those seen in septic shock. Chest 94:750–754

    Google Scholar 

  56. Motzer RJ, Bacik J, Schwartz LH, Reuter V, Russo P, Marion S, Mazumdar M (2004) Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 22:454–463

    Google Scholar 

  57. Bretheau D, Lechevallier E, Eghazarian C, Grisoni V, Coulange C (1995) Prognostic significance of incidental renal cell carcinoma. Eur Urol 27:319–323

    Google Scholar 

  58. Mickisch GH, Garin A, van Poppel H, de Prijck L, Sylvester R (2001) Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet 358:966–970

    Article  CAS  PubMed  Google Scholar 

  59. Negrier S (2004) Better survival with interleukin-2-based regimens? Possibly only in highly selected patients. J Clin Oncol 22:1174–1176

    Google Scholar 

  60. Ellerhorst JA, Sella A, Amato RJ, Tu SM, Millikan RE, Finn LD, Banks M, Logothetis CJ (1997) Phase II trial of 5-fluorouracil, interferon-alpha and continuous infusion interleukin-2 for patients with metastatic renal cell carcinoma. Cancer 80:2128–2132

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karl Rohrmann.

Additional information

K. Rohrmann and M. Staehler contributed equally to the project and are to be considered as co-first authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rohrmann, K., Staehler, M., Haseke, N. et al. Immunotherapy in metastatic renal cell carcinoma. World J Urol 23, 196–201 (2005). https://doi.org/10.1007/s00345-004-0470-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-004-0470-4

Keywords

Navigation