ABSTRACT
Response rates to combination chemotherapy1
and to hormonal agents2 in metastatic renal cell carcinoma (RCC) are only 5-10%. It has been known for some time that the immune system has a role in the natural history of RCC. For example, spontaneous regressions are rare but well described3,4
and immunotherapy with interferon (IFN) in metastatic disease produces response rates in the range of 10-20% with median response durations of 3-16 months.5 Randomized controlled trials have shown a survival advantage to IFN compared to non-immunotherapy.6,7
Treatment with high-dose intravenous interleukin-2 (IL-2) causes substantial toxicity but in non-randomized trials approximately 9% of patients with metastatic RCC will have a complete response (CR) to treatment and in 70-80% of these patients the responses are prolonged.8 There may therefore be a role for high-dose IL-2 in selected patients with metastatic RCC and good performance status.
