Chemo-immunotherapy in RCC: the end of a story.

摘要

Immunotherapy has been the only effective therapy for metastatic renal cell carcinoma (mRCC) for almost 20 years, with two active drugs, interleukin-2 and interferon-alfa, approved in Europe on the basis of the promising response rate for high-dose interleukin-2 or on survival advantage for interferon. In the 1990s, many attempts were made to improve the efficacy or the toxicity of these two agents. In the USA, interleukin-2 has been tested at a lower dose or with continuous intravenous infusion without detrimental effect on overall survival. In Europe, interleukin-2 and interferon have been combined to detect whether combination of these cytokines could improve survival. The first large randomised trial of cytokines in mRCC (the CRECY trial) did not show any advantage of either intravenous interleukin-2 or the combination of interleukin-2 with interferon over subcutaneous interferon