Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea.
ABSTRACT
PURPOSE: Recently in light of the development in immunology, interferon- e and inter- leukin-2 or combination therapy with anticancer drugs have been performed. This study aims to verify and compare the efficacy of therapies using interferon- a alone, interferon- a plus vinblastine, and interferon- a plus interleukin-2 plus 5-fluorouracil (5-FU) plus 13-cis retinoic acid (13cRA) in patients with advanced renal cell carcinoma.
MATERIALS AND METHODS: A total of 29 patients were randomly assigned to receive treatment with either interferon- a alone or interferon- a plus vinblastine or interferon- a plus interleukin-2 plus 5-FU plus 13cRA from December 1989 to May 1998. The most frequent metastatic sites were the lung, lymph nodes, bone, liver, and brain. We studied the response rates, survival period, and complications of each regimen.
RESULTS: Responses were achieved in 1 out of 1~5 patients (6.73?o) on interferon- a alone (partial responses lasting 13 months), 1 out of 9 patients (11.1%) on interferon- e plus vinblastine (partial responses lasting 25 months) and 1 out of 5 patients (20.0%) on interferon-a plus IL-2 plus 5-FU plus 13cRA regimen (partial responses lasting 14 months). The median durations of survival were 18, 33, and 23 months respectively. The overall response rate was 10.3% and overall median duration of survival was 19 months. The most common side effects were flu-like symptom such as fever, chills (93.1%), skin symptom such as erythema, pruritus (31.0%), G-I symptom such as nausea, vomiting (17.2%), netropenia (10.3%), abnormal LFT (10.3%), and thrombocytopenia (3.4%).
CONCLUSIONS: This study confirms the manageability and tolerability of several regimen used. There is no significant differences in response rates and survival duration among the regimens used in this study. The effective immunotherapy in patients with metastatic RCC should be evaluated by further studies of larger patients groups even though a minority of patients responded.
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